Abstract

A CROSS SECTIONAL STUDY TO SLOW DOWN THE PROGRESSION OF HYPERTENSION AND DIABETES MELLITUS INDUCED CHRONIC KIDNEY DISEASE

Gurigalla Srinivas*, A. Abhishek Sai, V. Shukla Bhavani, A. Srinivasa Rao and A. V. Kishore Babu

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Abstract

The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about 12 centimetres (4+1⁄2 inches) in length. They receive blood from the paired renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the bladder. In humans, the kidneys are located high in the abdominal cavity, one on each side of the spine, and lie in a retroperitoneal position at a slightly oblique angle. The asymmetry within the abdominal cavity, caused by the position of the liver, typically results in the right kidney being slightly lower and smaller than the left, and being placed slightly more to the middle than the left kidney. The left kidney is approximately at the vertebral level T12 to L3, and the right is slightly lower. The right kidney sits just below the diaphragm and posterior to the liver. The left kidney sits below the diaphragm and posterior to the spleen. On top of each kidney is an adrenal gland. The upper parts of the kidneys are partially protected by the 11th and 12th ribs. Each kidney, with its adrenal gland is surrounded by two layers of fat: the perirenal fat present between renal fascia and renal capsule and pararenal fat superior to the renal fascia. Objectives: To forestall the unusual degrees of HTN and DM levels and retard the movement of CKD. This can be accomplished by appropriate adherence of recommended prescriptions and keeping up with the reasonable way of life. To keep up with the bp focus at 120/80 mm hg. To keep up with the fasting glucose levels at 99mg/dl or according to the typical or consistent levels of the patien To keep up with the post prandial glucose levels exceptionally in grown-ups from 90-130mn/dl. to ensure that the patient is chipping away at way of life changes. Methodology: This is a cross sectional review with the target of dialing back the movement of persistent kidney sickness by managing the unusual upsides of hypertension and diabetes mellitus in patients who were introduced to yashoda Hospital. Subsequent to taking the consent from the ethical committee, the review has been led cross sectionally. In the wake of getting authorization to get to the patient's information from the case sheet documents or electronic clinical records, every one of the qualified members information will be gathered in information assortment structure which included segment subtleties like age, gender, weight, height, body mass index(BMI), body surface area(BSA), performance status (ECOG) alongside the accompanying laboratory parameters - complete blood picture (CBP), liver function tests (LFT), serum creatinine values, biopsy, CCGT abdomen, X-ray pelvis, PET - CT scans and other imaging reports will be assessed to evaluate the patient improvement Way of life alterations is the essential endpoint. Auxiliary endpoint remembers changes for treatment like expansion or expulsion of medications, changing the measurements and adjusting the dose routine. Patients are given directing about their way of life alterations which incorporate standard activity, ideal eating regimen as per their laboratory parameters of electrolytes, decrease of salt admission, required admission of water, eating new leafy foods, performing yoga, reflection meetings and lively strolls everyday, likewise about prescription adherence. Results: This study identifies that male patients (51%) are usually affected with hypertension or Diabetes mellitus induced CKD when compared to women patients (38%). By assessing the regular medication adherence and shifting the lifestyle habits to improve the quality of life, the progression of CKD can be usually slowed down. Out of total sample size it was found that 39% subjects with HTN and DM induced CKD have achieved the target of slowing down the progression or CKD whereas the remaining 11% have failed with few complications.

Keywords: Hypertension, Diabetes Mellitus, End stage renal disease (ESRD), Renal failure, Chronic kidney disease, Progression of CKD.