Introduction: The prevalence of chronic kidney disease (CKD) is estimated to be 12 times the cases of end stage renal disease (ESRD). CKD in earlier stages is generally asymptomatic. Early interventions delay the progression to ESRD and reduce morbidity and mortality.

Aims and objectives: To study the clinical profile of chronic kidney disease in a tertiary care hospital and determines the aetiology of chronic kidney disease and assess comorbidities.

Materials and methods: In a descriptive study, 130 consecutive patients of chronic kidney disease who attended or was admitted in a tertiary care hospital over 1 year. All patients were evaluated in detail and an aetiological diagnosis was made on each patient.

Results: 76.1% of the patients were males and rest were females with sex ratio of 3.2:1. Age of patients varied between 14 and 82 years of age, with mean age of 55.80 ±13.49 years. 28.5 % of all patients had Cardiovascular Diseases (CVD) and cerebrovascular accident was present in 5.4% of the patients. The most common symptom in patients from this study group was pedal oedema (59.2%), followed by anorexia (53.1%), breathlessness (30.7%), nocturia (27.7%), and weakness (25.4%). Only 3.1% patients had hyperphosphatemia.

Conclusion: The assessment of clinical profile of these patients showed the most common aetiology as diabetes mellitus (36.9%). Hypertension being a cause and a complication of CKD was present in 64.6% of patients. Early detection and effective management of these illnesses can delay the onset, progression of CKD and subsequent morbidity and the requirement of renal replacement therapy, if any.

Lupus nephritis is a severe organic manifestation of systemic lupus erythematosus. We studied 120 cases of patients diagnosed with systemic lupus erythematosus. Lupus nephritis was found in 41 patients (34.1%) with a mean age of 34 years and including 32 women and 9 men. Nephritis was the first sign of lupus in 66%. Renal clinical features were: swelling (39%), hypertension (25%), hematuria (25%), proteinuria (95%), nephrotic syndrome (46%) and renal failure (29%). Renal biopsy was contributive in 30 cases and showed glomerular nephritis class I in 2%, class III in 7%, class IV in 42%, class V in 15% and class IV+V in 7% of all cases. Induction therapy consisted of high dose corticosteroids in all patients, associated with IS therapy in 78% of the cases: cyclophosphamide in 29 patients and MMF in 3 patients. Maintenance therapy included low doses of corticosteroids in all patients in addition to cyclophosphamide in 3 cases, MMF in 10 cases and azathioprine in 10 patients. A complete remission was observed in 17 cases (41%), a partial remission in 20 cases (49%), a renal relapse in 20 patients (49%) and an end-stage renal failure in 9 patients (22%). Two patients died. Predictor factors of better outcome were achieving complete remission and a longer duration of maintenance therapy. Swelling, high rates of proteinuria, nephrotic syndrome, partial remission and short duration of maintenance therapy were identified as poor prognostic predictors.

Introduction: Acute Kidney Injury (AKI) is grave condition. It accounts about 35 % of mortality in all kidney disease. Fractional excretion of Sodium (FENa) has been used to differentiate between Pre renal & Intrinsic Renal Failure. Keeping on view of limitation to the use of FENa, Fractional Excretion of Urea Nitrogen (FEUN) has been emerged as an alternative to FENa in the differentiating the type of renal failure for diagnosis & intervention.

Material & Method: The children beyond neonatal period & upto14 years, those who presented with AKI to pediatric ward of SCB Medical College & hospital and SVP PG institute of Pediatrics, Cuttack during the period of October 2015 to September 2017 were taken into study.

Result: Incidence of AKI was found to be 1% of all hospitalized children.75% of patients presented with pre renal failure, intrinsic renal failure was seen in 25% cases. The diuretics have no effect on FEUN & FENa while evaluating intrinsic renal failure. FEUN is a more sensitive test to identify PRF cases from IRF among the patients presented as ARF.

Conclusion: The Fractional Excretion of Urea (FEUN) is a better indicator than fractional excretion of Sodium (FENa), in differentiating Pre Renal Failure (PRF) patients from Intrinsic Renal Failure (IRF) patient among those presented initially as Acute Kidney Injury.