A systematic study of the prevalence and risk factors of chronic kidney disease in Uddanam.

Abstract : Introduction Despite reports of 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 (uPCR) were measured using validated methodologies. All abnormal eGFR and uPCR values were reconfirmed after 3 months. A range of socio-demographic factors were evaluated for their association with CKD using Poisson regression. Results Out of 2402 eligible subjects (45.67±13.29 yr, 51% females), 506 (21.07%) had CKD (51.79±13.12 yr, 41.3% females). A total of 246 (10.24%) had eGFR 0.15 g/g). The post-stratified estimates, adjusted for age and sex distribution of the region for CKD prevalence are 18.7% (16.4, 21.0) overall, and 21.3% (18.2% , 24.4% ) and 16.2% (13.7%, 18.8%) in men and women, respectively. Older age, male sex, tobacco use, hypertension and family history of CKD were independently associated with CKD. Compared to those with higher eGFR, those with eGFR 0.15, except a lower frequency of males in the former. Conclusions We confirmed the high CKD prevalence of CKD in the adult population of Uddanam. The cause was not apparent in a majority. Subjects with low eGFR with or without elevated proteinuria were phenotypically disticct from those with proteinuria and preserved eGFR. Our data suggest the need to apply a population-based approach to screening and prevention and studies for the understanding of causes of CKD in this region.