Health Condition 1: N039- Chronic nephritic syndrome with unspecified morphologic changes Health Condition 2: N119- Chronic tubulo-interstitial nephritis, unspecified Health Condition 3: N08- Glomerular disorders in diseases classified elsewhere
Conditions
Interventions
Intervention1: Estimation of toxic metals, metallothionein and divalent metal ion transporter gene expression in both cases and controls: The blood samples will be drawn only at baseline - no follow-u
Sponsors
Dr Namrata Rao S
Eligibility
Inclusion criteria
Inclusion criteria: For CKDu - none of the conditions from exclusion criteria should be present Mandatory criteria - eGFR < 60 ml/min/1.73 m2 by CKD-EPI formula + ultrasonography (USG) showing small shrunken kidneys and/or Renal biopsy done shows chronic tubulointerstitial nephritis with no immune deposits
Exclusion criteria
Exclusion criteria: Exclusion criteria include the presence of CKD due to any of the etiologies mentioned as below: a.) Diabetic kidney disease: Diabetes mellitus identified using American Diabetes Association (ADA) criteria for fasting and postprandial blood glucose levels or if the patient has been receiving hypoglycemic agents and has fundus findings of diabetic retinopathy alongwith proteinuric kidney disease (urinary protein excretion of > 1.5 g/day or dipstick value of ++ or more), or has renal biopsy findings of diabetic nephropathy, will be presumed to have diabetic kidney disease. b.) Hypertensive nephrosclerosis: CKD will be attributed to hypertensive nephrosclerosis if the patient had documented systemic hypertension for >5 years before the diagnosis of CKD or with severe hypertension (requiring more than 2 antihypertensives or blood pressure >160/100 mm Hg) or fundus findings of chronic hypertensive retinopathy at any time in the absence of other causes of CKD. c.) Chronic glomerulonephritis: Chronic glomerulonephritis will be diagnosed if kidney biopsy shows evidence of glomerulonephritis or if a patient with CKD had a history of long-standing edema and/or proteinuria > ++ or >1.5 g/day. d.) Chronic tubulointerstitial nephritis: The diagnosis of chronic tubulointerstitial disease will be made either on histology or based on a compatible history, the presence of vesicoureteral reflux, and/or recurrent urinary tract infection. e.) Others: Obstructive uropathy, renal stone diease, and cystic disease will be diagnosed if there are confirmatory findings seen on imaging studies. The diagnosis of renovascular disease will be made from Doppler study or angiography. Kidney disease in association with specific â??syndromesâ?? will be diagnosed by characteristic clinical findings, family history, and laboratory abnormalities.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To compare the serum levels of heavy metals and metabolizing enzymes, metallothionein and DMT1 among CKDu cases and known CKD controlsTimepoint: Only at baseline - no follow-up | — |
Secondary
| Measure | Time frame |
|---|---|
| To compare environmental and occupational risk factors between patients showing elevated levels of heavy metals and patients without elevated levelsTimepoint: 2 years | — |
Countries
India
Contacts
Public ContactNamrata Rao S
Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow
Outcome results
None listed