A RETROSPECTIVE PREVALENCE STUDY OF DRUG INDUCED NEPHRITIS- A HOSPITAL BASED CROSS SECTIONAL STUDY IN CENTRAL INDIAN POPULATION

Abstract

Background: Drug-induced kidney disease constitutes an important cause of acute renal failure and chronic kidney disease in present day clinical practice. Different classes of drugs, by virtue of immunological mechanisms or direct toxicity initiate certain stereotyped renal responses.

Objectives: To estimate the incidence and prevalence of drug induced nephrotoxicity, a retrospective study was conducted in the Department of Medicine, Sri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh, over a period of 6 months from January 2018 to June 2018. The study included 120 determinations of drug induced nephritis between 30-70 years age group. 49.5% of patients were female.

Methods: screening of 500 people aged 30 and above was carried out. Demographic and anthropometric data were obtained, urine was analyzed for protein by dipstick and serum creatinine was measured in all participants. Glomerular filtration rate was estimated (eGFR) using the 4-variable modification of diet in renal disease (MDRD) equation and Cockcroft-Gault equation corrected to the body surface area (CG-BSA).

Results: proteinuria was 2.8%. DIN was seen in 120(6.3%) subjects when GFR was estimated by MDRD equation. The prevalence of DIN was 24% by the CG-BSA method. There was a statistically significant relationship of DIN with gender, advancing age, abdominal obesity, smoking, presence of diabetes and hypertension. The wide difference between the DIN prevalence between MDRD and CG-BSA equations suggests the need for a better measure of kidney function applicable to Indian population. CG-BSA equations suggests the need for a better measure of kidney function applicable to Indian population.

Keywords: Body mass index (BMI), Cockcroft-Gault (CG), Chronic kidney disease (CKD), drug induced nephrotoxicity (DIN), Proteinuria, Glomerular filtration rate (GFR)