A Systematic Study of the Prevalence and Risk Factors of CKD in Uddanam, India
Balaji Gummidi, Oommen John, Arpita Ghosh, Gopesh K. Modi, Meena Sehgal, Om P. Kalra, Vijay Kher, Jayaprakash Muliyil, Jarnail Singh Thakur, Lakshmy Ramakrishnan, Chandra M. Pandey, Vishnubhotla Sivakumar, Rupinder Singh Dhaliwal, Tripti Khanna, Aruna Singh, Geetha Prasadini, Janardhan C. Reddy, Jawahar Reddy, Vivekanand Jha
Abstract
INTRODUCTION: Despite reports of a high prevalence of chronic kidney disease (CKD) from the coastal Uddanam region of Andhra Pradesh, India, there are no accurate data on the distribution of kidney function abnormalities and CKD risk factors in this region. METHODS: A total of 2419 participants were recruited through multistage cluster random sampling from 67 villages. Serum creatinine and urine protein creatinine ratio were measured using validated methodologies. All abnormal estimated glomerular filtration rate (eGFR) and urine protein creatinine ratio values were reconfirmed after 3 months. A range of sociodemographic factors were evaluated for their association with CKD using Poisson regression. RESULTS: were older, were more likely to be uneducated, manual laborers/farmers, or tobacco users, and were more likely to have hypertension, a family history of CKD, a diagnosis of heart disease, and a lower body mass index. Among those with low eGFR, there was no difference between those with urine protein creatinine ratio <0.15 or >0.15, except a lower frequency of males in the former. CONCLUSION: We confirmed the high prevalence of CKD in the adult population of Uddanam. The cause was not apparent in a majority. Subjects with a low eGFR with or without elevated proteinuria were phenotypically distinct from those with proteinuria and preserved eGFR. Our data suggest the need to apply a population-based approach to screening and prevention and studies to understand the causes of CKD in this region.