END-STAGE RENAL DISEASE PREVALENCE, MANAGEMENT, AND ASSOCIATION WITH DIABETES AND HYPERTENSION: A CROSS-SECTIONAL STUDY IN SOUTH PUNJAB, PAKISTAN

Abstract

Diabetes and hypertension have greatly increased end-stage renal disease (ESRD) in developing countries, like Pakistan, which requires early diagnosis and management to prevent ESRD. Blood samples were collected from patients suspected of having ESRD and processed for the identification of diabetes and ESRD, with measurement of hypertension in South Punjab, Pakistan. This cross-sectional study aimed to determine the prevalence of ESRD, its management, and the association with hypertension and diabetes. Out of 126 participants, 36 (28.6%) were healthy and 90 (71.4%) had ESRD, including 50 (55.6%) with hypertension + ESRD, 27 (30%) with diabetes + hypertension + ESRD, 10 (11.1%) with ESRD alone, and 3 (3.3%) with diabetes + ESRD. Healthy and ESRD families had hypertension (55% and 50%), diabetes (44.4% and 36.7%), and renal issues (13.9% and 21.1%). Compared to ESRD patients, healthier individuals were more active, non-smokers, non-obese, and taking and eating healthily (97.1% - 77.8%). Except for 24%, ESRD patients had diabetes (31.1%) and hypertension (58.9%) before diagnosis. ESRD patients had 8.9% type I diabetes, 17.8% type II, and 73.3% uncertainty. In binary logistic regression analysis, age, married status, family with diabetes and hypertension, lack of physical exercise, and poor diet increased ESRD risk. ESRD was significantly associated with age, marital status, physical activity, healthy diet, diabetes/hypertension diagnosis, and management (p <0.05), but not with gender, location, or family history (p=>0.05). Our study found a high prevalence of ESRD among diabetic and hypertensive patients. Sociodemographic, clinical and management factors also increased the risk for ESRD, emphasizing the need for awareness, early diagnosis, and effective treatment.