A PROSPECTIVE, OBSERVATIONAL STUDY ON ETIOLOGICAL SPECTRUM OF END STAGE KIDNEY DISEASE IN NORTH INDIA: DOMINANCE OF DIABETIC KIDNEY DISEASE AND EMERGING TRENDS

Background: End-stage kidney disease (ESKD) poses a formidable challenge to healthcare systems worldwide, particularly in low-and middle-income countries like India.With the epidemiological transition favoring noncommunicable diseases, the burden of diabetes and hypertension as leading causes of chronic kidney disease (CKD) has grown substantially.This study aims to characterize the etiological spectrum of ESKD in a North Indian tertiary care center, with a special focus on the rising prevalence of diabetic kidney disease (DKD).Methods: A cross-sectional observational study was conducted between June 2023 and December 2024, enrolling 132 patients undergoing incident hemodialysis.Data on demographics, comorbidities, clinical symptoms, laboratory parameters, and underlying CKD etiologies were collected and analyzed.Results: DKD was identified as the most common cause of ESKD [n=50 (40.9%)], followed by hypertensive nephrosclerosis [n=19(14.4%)],chronic glomerulonephritis [n=13(9.8%)],and unknown etiology [n=19(14.4%)].Other causes included hepatorenal syndrome-associated CKD [n=8(6.1%)],obstructive uropathy [n=7(5.3%)],polycystic kidney disease [n=6(4.6%)],and chronic tubulointerstitial nephritis [n=6(4.6%)]. Conclusion: DKD is the predominant cause of ESKD in this cohort from NorthIndia.Early diagnosis, risk factor management, and nephrology referral are crucial.Regional profiling of etiologies can improve health planning and resource allocation.