The incidence of end-stage renal disease in India: A population-based study

Abstract

Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are emerging public health problems in developing countries, and need changes in health-care policy. ESRD incidence data are not available from large parts of the developing world including South Asia. We report the ESRD incidence in a large urban population in India. ESRD incidence was estimated for four consecutive calendar years (2002-2005) among 572 029 subjects residing in 36 of the 56 wards of the city of Bhopal. These subjects are beneficiaries of free health care in a hospital established after the 1984 Union Carbide Industrial Accident. Crude and age-adjusted incidence rates were calculated. A total of 346 new ESRD patients were diagnosed during the study period; 86 in 2002, 82 in 2003, 85 in 2004, and 93 in 2005. Average crude and age-adjusted incidence rates were 151 and 232 per million population, respectively. The mean age was 47 years, and 58% were males. Diabetic nephropathy was the commonest (44%) cause of ESRD. This study provides the first population-based ESRD incidence data from India and reveals it to be higher than previously estimated. Diabetic nephropathy is the leading cause of ESRD. Changes are required in health-care policy for optimal care of CKD patients and efficient resource utilization for management of those with ESRD.

Patient Profile of Diabetic Individuals, Attending Primary Care Diabetic Clinic, In Karimnagar, Telangana

“…Lean Diabetics were those diabetics who had other features of diabetes but were of BMI of around 18, and could maintain their sugars on OHAs as other T2DM individuals, Pancreatic Diabetes and GDM as an entity was made but the enrollment of the patient in the study was not done. Microalbuminuria prevalence in our study was found in around 9 percent of individuals which is at par with other reported studies, although the prevalence of known CKD a variable which was defined in our studies as individuals already a proven case and under nephrology treatment, and hence a lower prevalence of around 2.5 percent can be understood in our study, with eGFR studies at par prevalence would have been seen (68)(69)(70)(71) . Microalbuminuria was found to be statistically significantly associated with hypertension, P value <0.036, duration of diabetes and level of sugar control were not found to be statistically significant in our study.…”

Diabetic Foot Infection and Worsening Kidney Function: Implication for Health Care in the Developing World

“…Patients with declining eGFR are prone to DFI. In a developing country, the burden of CKD is higher [8] and it is further escalated due to DFI. If DFI occurs in patients with CKD stage 3 and stage 4, it may worsen the GFR decline and lead to ESRD.…”

“…Indians are at heightened risk for nephropathy, more than any other ethnic groups and declining of GFR was also faster. T2DM patients in India are at high risk of developing Chronic Kidney disease (CKD) and diabetes is now the leading cause of end stage renal disease (ESRD) in many regions of India [8]. The burden of CKD among the DM remains to be a global threat, as the treatment is expensive and lifelong.…”

Report of the Asian Forum of Chronic Kidney Disease Initiative (AFCKDI) 2007. “Current status and perspective of CKD in Asia”: diversity and specificity among Asian countries

“…India (V. Jha) CKD, diabetes and hypertension have been identified as increasing in prevalence in several small surveys. Diabetes is the commonest cause of end-stage renal diseases (ESRD); 73% of ESRD patients present less than 3 months before diagnosis [12].…”