title: Attributable causes of chronic kidney disease in adults: a five-year retrospective study in a tertiary-care hospital in the northeast of the Malaysian Peninsula.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is an escalating medical and socioeconomic problem worldwide. Information concerning the causes of CKD, which is a prerequisite for reducing the disease burden, is sparse in Malaysia. Therefore, this study aimed to evaluate the attributable causes of CKD in an adult population at a tertiary referral hospital.
  
  
  METHODS
  Retrospective study at Hospital Universiti Sains Malaysia (HUSM).
  
  
  METHODS
  This was an analysis based on medical records of adult patients at HUSM. Data regarding demographics, laboratory investigations, attributable causes and CKD stage were gathered.
  
  
  RESULTS
  A total of 851 eligible cases were included. The patients' mean age was 61.18 ± 13.37 years. CKD stage V was found in 333 cases (39.1%) whereas stages IV, IIIb, IIIa, and II were seen in 240 (28.2%), 186 (21.9%), 74 (8.7%) and 18 (2.1%), respectively. The percentage of CKD stage V patients receiving renal replacement therapy was 15.6%. The foremost attributable causes of CKD were diabetic nephropathy (DN) (44.9%), hypertension (HPT) (24.2%) and obstructive uropathy (9.2%). The difference in the prevalence of CKD due to DN, HPT and glomerulonephritis between patients ≤ 50 and > 50 years old was statistically significant.
  
  
  CONCLUSIONS
  Our results suggest that DN and HPT are the major attributable causes of CKD among patients at a Malaysian tertiary-care hospital. Furthermore, the results draw attention to the possibility that greater emphasis on primary prevention of diabetes and hypertension will have a great impact on reduction of hospital admissions due to CKD in Malaysia.
authors.affiliation: Department of Pharmacy Practice, University College of Pharmacy, University of the Punjab, Lahore-54000, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Salman
authors.affiliation: School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
authors.forename: Amer Hayat
authors.initials: AH
authors.lastname: Khan
authors.affiliation: Chronic Kidney Disease Resource Centre, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
authors.forename: Azreen Syazril
authors.initials: AS
authors.lastname: Adnan
authors.affiliation: School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
authors.forename: Syed Azhar Syed
authors.initials: SA
authors.lastname: Sulaiman
authors.affiliation: University College of Pharmacy, University of the Punjab, Lahore-54000, Pakistan.
authors.forename: Khalid
authors.initials: K
authors.lastname: Hussain
authors.affiliation: University College of Pharmacy, University of the Punjab, Lahore-54000, Pakistan.
authors.forename: Naureen
authors.initials: N
authors.lastname: Shehzadi
authors.affiliation: Department of Gynecology and Obstetrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
authors.forename: Fauziah
authors.initials: F
authors.lastname: Jummaat
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014517:Ureteral Obstruction / Q000150:complications / Q000453:epidemiology; D055815:Young Adult