# Emergency Department Presentations of Chronic Kidney Disease in a Tertiary Hospital of Nepal: An Observational Study

## TL;DR

This study estimates the prevalence of chronic kidney disease and its complications in Nepal's emergency department, finding anemia and hypertension as the most common issues.

## Contribution

The study provides new prevalence data and complication insights for chronic kidney disease in a Nepalese hospital's emergency department.

## Key findings

- Chronic kidney disease prevalence in the emergency department was 2.5%.
- Anemia and hypertensive crisis were the most common complications among CKD patients.
- Mortality rate among CKD patients in the emergency department was 1.2%.

## Abstract

Progressive chronic kidney disease is associated with complications like hypertension, anemia, mineral bone disorder, metabolic acidosis and electrolyte disorders which lead to higher morbidity, mortality and poorer quality of life. Available estimates of chronic kidney disease cases and those receiving treatment suggests an existing gap in care. Therefore, this study aims to estimate the prevalence of chronic kidney disease and its complications in the emergency department of Tribhuvan University Teaching Hospital.

A cross-sectional descriptive study was done. The participants were chronic kidney disease patients with complications visiting the Emergency Department of Maharajgunj Medical Campus. Census sampling technique was used to enroll all chronic kidney disease patients with complications meeting inclusion criteria, visiting the Emergency Department from 11th October 2023 to 19th September 2024. Ethical approval was obtained from the institutional review committee of the Institute of Medicine, Maharajgunj with the reference number 509(6-11)E2/081/082. Distribution check and descriptive analysis was done using STATA.

The prevalence of chronic kidney disease was found to be 2.5%. The most common complications were anemia 399 (53.69%) and hypertensive crisis 396 (53.29%). Least common complications among CKD patients was sepsis 8 (1.08%). Several other complications like arrhythmia, nephropathy, hypoglycemia, obstructive uropathy, pericardial effusion, urinary tract infection, pleural effusion, pneumonia were observed in 50 (6.73%) of the CKD patients. Death as an outcome was reported in 9 (1.2%) of total patients.

Chronic kidney disease proportion in emergency departments is high, with anemia and hypertension being common complications. Targeted interventions might include establishing hemodialysis units and increasing staff awareness.