Chronic renal failure: An autopsy study

Area of Science:

• Nephrology
• Pathology
• Epidemiology

Background:

• Diabetes and hypertension are leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally.
• Chronic renal failure (CRF), typically CKD stages 3-5, presents significant morbidity and mortality, primarily due to cardiovascular disease.
• Understanding the demographics, clinical presentations, and etiological factors of CRF is crucial for patient management.

Purpose of the Study:

• To analyze the age and sex distribution of CRF patients.
• To detail the clinical features, pathological findings, and causes of death in CRF.
• To identify the primary etiologies of CRF in a tertiary care hospital setting in India.

Main Methods:

• A retrospective autopsy-based study of known and newly diagnosed CRF cases over a 7-year period.
• Inclusion criteria encompassed all autopsies performed on CRF patients.
• Data collected included patient demographics, clinical history, and detailed pathological examination of organs.

Main Results:

• The highest incidence of CRF was observed in the 56-65 year age group, with a male to female ratio of 1.38:1.
• Oliguria and anasarca were the most frequent clinical manifestations.
• Chronic pyelonephritis emerged as the leading cause of CRF, followed by hypertension, diabetes, and chronic glomerulonephritis.

Conclusions:

• Cardiovascular disease remains the predominant cause of mortality in CRF patients.
• Infections, cerebrovascular events, and metabolic complications also contribute significantly to CRF mortality.
• Chronic pyelonephritis is a major etiological factor for CRF in the studied population, highlighting the need for targeted prevention and treatment strategies.