ISLAMABAD - As many as 70 renal failure patients daily visited the dialysis centre of the Pakistan Institute of Medical Sciences to receive free services and medication for eliminating waste and unwanted water from the blood.

Nephrologist and Head of Kidney Transplant Unit at PIMS Dr Khawar Sultan said that the Nephrology unit at PIMS, which was part of a large tertiary care hospital, catered to a large population in the region.

He said that the average population served by the centre belonged to a vast area of Punjab, Khyber Pakhtunkhwa, Azad Jammu and Kashmir and the federal capital. He said that there was a separate dedicated chronic kidney disease (CKD) clinic and transplant unit, besides the outpatient department (OPD) at PIMS.

Dr Khawar said sufficient number of paramedical staff, nurses and doctors performed their duties at the dialysis centre and Nephrology ward at the PIMS to serve the incoming patients.

He said that in case of failure of kidneys, dialysis keeps human body in balance by removing waste, salt and extra water to prevent them from building up in the body, keeping a safe level of certain chemicals in blood, such as potassium, sodium and bicarbonate and helping to control blood pressure.

He said that in order to prevent from renal failure and to avoid from future medical complications, people should go for early investigation or detailed medical check up on suspicion of kidney disease.

He added keeping in view the increasing burden of chronic kidney disease in Pakistan, there was a need for aggressive screening to check the presence of kidney disease in population.

Dr Khawar Sultan said that the probability of Chronic Kidney Disease (CKD) in different age groups is increasing in Pakistan due to diabetes.

He said that according to a recent research conducted at PIMS, the annual incidence of new cases of end-stage renal disease (ESRD) was 100 per million population in Pakistan while diabetes was the leading cause of CKD.

He said the research also revealed that the chronic kidney disease was progressively increasing in South Asian countries like Pakistan and the reason for it was multifactorial.

He said that most of the people had inadequate knowledge about healthcare provision due to lack of health education and most importantly, the increasing prevalence of risk factors for CKD such as diabetes and hypertension. In addition, other causes like glomerulonephritis and renal stones were prevalent due to infections and dry weather conditions, Dr Khawar added.

He said a total of 500 patients were considered for final analysis based on data adequacy. The average age of the population was 46 years, with the minimum age of 20 years and the maximum being 83 years.

The common causes of CKD identified in the patients included diabetic nephropathy 28 per cent (140 patients), glomerulonephritis 22 per cent (110 patients), hypertension 14.6 per cent (73 patients), tubulo-interstitial disease 13.4  per cent (67patients)and renal stone disease 8 per cent (40 patients, he added.

Dr Khawar said the cause was unknown in a significant percentage of patients which was 10.6 per cent ((53 patients). Other causes including post-partum renal failure, constituted 2 per cent of the cases.

He said 268 of the patients were below the age of 50 years. The common etiology of CKD in that age-group included glomerulonephritis (33.2 per cent), diabetic nephropathy (17.9 per cent), tubulo-interstitial disease (10 per cent) and renal stone disease (13.8 per cent). The patients who had CKD of unknown cause comprised 12.31 per cent.

Among the 232 patients, who were over 50 years, the causes of CKD were identified as diabetic nephropathy (39.6 per cent), hypertension (19.8 per cent), renal stone disease (12.9 per cent), tubulointerstitial disease (5.6 per cent) and adult polycystic kidney disease (3 per cent). Only 8.6 per cent of patients in this age-group had CKD of unknown etiology.

Dr Khawar said CKD was a worldwide public health issue, the incidence and prevalence of which were increasing, resulting in high cost and poor outcomes.