Chronic renal failure in India

Mk, Mani

doi:10.1093/ndt/8.8.684

Cited by 59 publications

(37 citation statements)

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“…The domiciliary screening program for CKD by a trust in South India has reported the prevalence of CKD stage 5 to be 0.87 per thousand (870 per million) [9], which is also very similar to extrapolation of an earlier study from North India [5]. In addition to these three community-based studies, there are few hospital-based studies on CKD/ESRD which are restricted to primarily commenting on the etiology of CKD patients presenting to the hospital [10,11,12,13]. There are some differences among these studies which are difficult to resolve, as differentiating chronic glomerulonephritis from chronic interstitial disease is very difficult once a patient comes at a stage where a definitive diagnosis cannot be made.…”

Section: Chronic Kidney Disease In Indiasupporting

confidence: 59%

Chronic Kidney Disease in India: Challenges and Solutions

2009

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Chronic diseases have become a major cause of global morbidity and mortality even in developing countries. The burden of chronic kidney disease (CKD) in India cannot be assessed accurately. The approximate prevalence of CKD is 800 per million population (pmp), and the incidence of end-stage renal disease (ESRD) is 150–200 pmp. The most common cause of CKD in population-based studies is diabetic nephropathy. India currently has 820+ nephrologists, 710+ hemodialysis units with 2,500+ dialysis stations and 4,800+ patients on CAPD. There are 172+ transplant centers, two-thirds of which are in South India and mostly privately run. Nearly 3,500 transplants are done annually, the total number of cadaver donors being approximately 700 till now. Thus, taken together, nearly 18,000–20,000 patients (10% of new ESRD cases) in India get renal replacement therapy. The cost of single hemodialysis varies between USD 15 and 40 with an additional cost of erythropoietin being USD 150–200/month. The cost of CAPD using a ‘Y’ set with 3 exchanges/week is USD 400/month. The cost of the transplant procedure in a state-run hospital is USD 800–1,000, and the cost of immunosuppression using tacrolimus, steroid and mycophenolate is USD 350–400/month. Until recently, the government did not recognize CKD/ESRD as a significant problem in India. However, some illustrious activities in relation to CKD brought attention of the media and policymakers to this very common but till now deprived group of diseases. On the one side the government has initiated a process by which it is planning to establish stand-alone hemodialysis units in the country to increase the facilities at an affordable cost, and on the transplant side it had launched a National Organ Transplant Program to facilitate transplantation on a national scale. Hemodialysis program is halfway to being implemented. Thus, in India there is still a long way to go with respect to CKD. Until then, in a country like India, screening of high-risk individuals for CKD and the risk factors is the best bet.

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Section: Chronic Kidney Disease In Indiasupporting

confidence: 59%

Chronic Kidney Disease in India: Challenges and Solutions

2009

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“…Similar to Mesoamerican nephropathy, there is also some evidence that this disease has been present for decades but has increased in recent years. Indeed, Mani reported in 1993 that chronic tubulointerstitial nephritis (diagnosed based on clinical presentation of small kidneys with no history of edema, minimal proteinuria, and an absence of diabetes and hypertension) was the most common cause of CKD in his unit in Madras, especially among the rural farmers of the area, where it constituted 40% of all cases of CKD (80).…”

Section: The Epidemics Of Ckd In Indiamentioning

confidence: 99%

Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy

Glaser¹,

Lemery²,

Rajagopalan³

et al. 2016

CJASN

330

264

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Climate change has led to significant rise of 0.8˚C-0.9˚C in global mean temperature over the last century and has been linked with significant increases in the frequency and severity of heat waves (extreme heat events). Climate change has also been increasingly connected to detrimental human health. One of the consequences of climate-related extreme heat exposure is dehydration and volume loss, leading to acute mortality from exacerbations of pre-existing chronic disease, as well as from outright heat exhaustion and heat stroke. Recent studies have also shown that recurrent heat exposure with physical exertion and inadequate hydration can lead to CKD that is distinct from that caused by diabetes, hypertension, or GN. Epidemics of CKD consistent with heat stress nephropathy are now occurring across the world. Here, we describe this disease, discuss the locations where it appears to be manifesting, link it with increasing temperatures, and discuss ongoing attempts to prevent the disease. Heat stress nephropathy may represent one of the first epidemics due to global warming. Government, industry, and health policy makers in the impacted regions should place greater emphasis on occupational and community interventions.

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“…Chronic renal failure is characterized by progressive irreversible kidney damage caused by progressive primary renal disease and renal damage owing to other systemic diseases [1][2][3]. Progressive renal failure is often relentless, leading to end-stage renal failure.…”

Section: Introductionmentioning

confidence: 99%

“…Progressive renal failure is often relentless, leading to end-stage renal failure. In a recent study [1] from India, chronic nephritis including chronic glomerulonephritis, chronic interstitial nephritis and chronic pylonephritis emerged as the commonest cause of renal failure. Other causes of renal failure were diabetic nephropathy, hypertensive nephrosclerosis and polycystic kidney disease.…”

Section: Introductionmentioning

confidence: 99%

Randomized, Double-blind Placebo-controlled Trial of Coenzyme Q10 in Chronic Renal Failure: Discovery of a New Role

Khanna

Niaz

2000

Journal of Nutritional & Environmental Medicine

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Purpose: Antioxidant vitamin and coenzyme Q10 de ciency as well as oxidative damage have been observed in patients with chronic renal failure. In this study, we examine whether treatment with coenzyme Q10 can improve renal function in chronic renal failure. Design: Randomized, double-blind, placebo-controlled trial. Materials and Methods: Subjects (n 5 21) with available records of chronic renal failure on dialysis or not on dialysis (serum creatinine 5 mg dl 2 1 or above) were randomly divided into intervention (n 5 11) and control (n 5 10) groups by blindly selecting a card. The intervention group was administered coenzyme Q10 (60 mg thrice daily) and the placebo group inert bre (cellulose, 1 g thrice daily) for a period of 4 weeks. Results: The coenzyme Q10 group showed a signi cant reduction in serum creatinine, blood urea and a signi cant increase in creatinine clearance and urine output compared to the placebo group after the 4-week trial period, while the baseline values of these parameters were comparable between the two groups. The frequency of dialysis and the proportion of subjects on dialysis were comparable at baseline. However, after 4 weeks, the subjects on dialysis were signi cantly fewer in the coenzyme Q10 group than the placebo group (36.2% vs. 90.0%, p , 0.02). Plasma levels of antioxidant vitamins A, E and C and beta-carotene showed a signi cant increase whereas thiobarbituric acid reactive substances, diene conjugates and malondialdehyde showed a signi cant reduction in the coenzyme Q10 group compared to the control group. Conclusions: Treatment with coenzyme Q10 improves renal function in patients with chronic renal failure and decreases the need for dialysis in patients on chronic dialysis. Long-term follow-up in a large number of patients would be necessary to con rm these results.

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Chronic renal failure in India

Cited by 59 publications

References 0 publications

Chronic Kidney Disease in India: Challenges and Solutions

Chronic Kidney Disease in India: Challenges and Solutions

Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy

Randomized, Double-blind Placebo-controlled Trial of Coenzyme Q10 in Chronic Renal Failure: Discovery of a New Role

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