Laiba Naveed Khan

Background:Chronic kidney disease (CKD) is amajor global health concern, and hypertension is one of its leading causes and contributors. Early detection and interventionare critical to reducingCKDprogressionandassociatedcomplications, especiallyinresource-constrainedsettingslikePakistan.Objective:Thisstudyaimedto determine the prevalence of CKDamong hypertensive patients and to identify key demographic, clinical, and biochemical factors associated with CKD progression. Methodology: A retrospective cross-sectional study was conducted in tertiary care hospitalsofPakistan,including273hypertensivepatientsfromMarch2023toSeptember 2023.CKDwasclassifiedusingtheestimatedGlomerularFiltrationRate(eGFR)and Albumin-to-CreatinineRatio(ACR) basedonKDIGOguidelines.Datawereanalyzed using bivariate analysis (chi-square tests) andmultivariable logistic regression to identify predictors of CKD. Results&Findings: Among 273 patients, 57.1%were diagnosedwithCKD. Thehighest prevalencewas observed inStage3CKD(35%), followedbyStage4(15%)andStage5(7.1%).SignificantpredictorsofCKDincluded age>60years(OR:2.8;95%CI:1.9–4.0;p<0.001),diabetes(OR:3.2;95%CI:2.0–5.0; p<0.01), andhypertensionduration>10years (OR:2.5;95%CI:1.7–3.7;p<0.001). BiochemicalanalysisshowedaprogressiveincreaseinACRandadeclineineGFRwith advancing CKD stages, reflecting severe renal impairment in advanced stages. Conclusion: CKD is highly prevalent among hypertensive patients, with older age, diabetes, andprolongedhypertension identifiedaskeyrisk factors.Routinescreening using eGFR and ACR is essential for early detection andmanagement. Targeted interventions forhigh-riskgroupsarecritical tomitigatingCKDprogressionand its associatedburden. Keywords: Chronickidneydisease,Hypertension, Prevalence, Albumin-to-Creatinine Ratio,EstimatedGlomerularFiltrationRate,Riskfactors,Pakistan,Retrospectivestudy, CKDstaging.

Bleeding is common in cardiopulmonary bypass (CPB) surgery due to malfunctioning platelets. This study investigated the effect of a phosphorylcholine (PC)-coated CPB circuit and a balanced CPB circuit on platelet function. We conducted a descriptive, randomized trial at the Punjab Institute of Cardiology with 50 patients undergoing coronary artery bypass graft (CABG) surgery (n=34), valve surgery (n=10), and CABG plus valvular replacement (n=6) using CPB. The patients were divided into groups 1, which had phosphoryl-coated CPB, and 2, which had balanced-coated CPB. We measured and recorded pre- operative and post-operative levels of platelet count, white blood cells, and hemoglobin for both groups. We used the Student's t- test to make comparisons among groups, and the P values for both groups were less than 0.05 at a 95% confidence interval, indicating a significant impact of biocompatible coated CPB circuits on circulating platelet drop. Cohen's d formula showed that group 1 (Phosphoryl choline coating) had a more substantial effect on platelet drop than group 2 (Balanced coating). Blood component conservation, particularly platelet conservation, depends on the non-endothelium biocompatible surface used; the better the character, the more blood cells may be conserved. We looked at two coatings, phosphoryl coating, and balanced coating, to see if they substantially influenced platelet drop. According to the findings of our investigation, phosphoryl-coated CPB had a more significant influence on platelet drop than balanced coating.