The Indian Chronic Kidney Disease (ICKD) study: baseline characteristics

Abstract

Background Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. There is lack of information on epidemiology and progression of CKD in low-middle income countries. The Indian Chronic Kidney Disease (ICKD) study aims to identify factors that associate with CKD progression, and development of kidney failure and cardiovascular disease (CVD) in Indian CKD patients . Methods ICKD study is prospective, multicentric, cohort study enrolling patients with estimated glomerular filtration rate (eGFR) 15-60 ml/min/1.73m2 or > 60 ml/min/1.73m2 with proteinuria. Clinical details and biological samples are collected at annual visit. We analysed the baseline characteristics including socio-demographic details, risk factors, disease characteristics and laboratory measurements. In addition, we compared characteristics between urban and rural participants. Results A total of 4056 patients have been enrolled till March 31, 2020. The age was 50.3 ±11.8 years, 67.2% were males, 2/3 lived in rural areas and median eGFR was 40 ml/min/1.73m2. About 87% were hypertensive, 37% had diabetes, 22% had CVD, 6.7% had past history of acute kidney injury and 23% reported prior use of alternative drugs. Diabetic kidney disease, chronic interstitial nephritis and CKD-cause unknown were the leading causes. Rural participants had more occupational exposure and tobacco use but lower educational status and income. CIN and unknown categories were leading causes in rural participants. Conclusions The ICKD study is the only large cohort study of patients with mild-to-moderate CKD in a lower-middle income country. Baseline characteristics of study population reveal differences as compared to other cohorts.

A retrospective case - control study for assessing the risk factors for development of Diabetic Kidney Disease among people with Type 2 Diabetes in Tamil Nadu and Puducherry

“…The ratio being 2:1 for DKD participants and 11:4 for T2D participants, respectively and was statistically significant. Our findings align with earlier studies that have reported higher prevalence of T2D and DKD among Indian men compared to women (Kumar et al 2022) (Ramachandran et al 1988) (Yu et al 2012). Additionally, studies like UKPDS 74 study, where Retnakaran and his coworkers found male sex as a risk factor for DKD.…”

“…There are few studies published on the prevalence of diabetic nephropathy in India (Kumar et al 2022), (Tewari et al 2021). Efforts have also been made to understand the prevalence, and determinants associated with CKD at regional level (Parameswaran et al 2020;Bala et al 2021;Eswarappa et al 2022).…”

“…Efforts have also been made to understand the prevalence, and determinants associated with CKD at regional level (Parameswaran et al 2020;Bala et al 2021;Eswarappa et al 2022). Although attempts have been made in countries like India (Kumar et al 2022), but still limited information is available around baseline characteristics of DKD not only at regional level but also at national level. Hussain and coworkers conducted the study to assess the awareness of kidney disease among T2D patients in India and found that 56% of them had poor information around kidney function (Hussain et al 2019).…”

Burden and outcomes of chronic kidney disease in patients presenting with hypertensive crisis

“…5 The Indian Chronic Kidney Disease (ICKD) study with 4056 prospectively enrolled patients across 11 centers with mild to moderate CKD showed that DM was seen in a quarter of patients followed by chronic interstitial nephritis and unknown etiology. 22 The prevalence of hypertension in CKD varies from 35.8% in stage 1 to 84.5% in stage 5, with a higher prevalence in renovascular diseases. 23 The population-level prevalence of CKD in adults with hypertension in South Asia was 27% (CI 20-35%).…”

Renin-angiotensin blocker use is associated with improved cardiovascular mortality in Indian patients with mild-moderate chronic kidney disease—findings from the ICKD study

“…The details of the ICKD cohort study design have already been published ( 13 ). Briefly, the study is recruiting adult participants with mild to moderate CKD; estimated glomerular filtration rate (eGFR) between 15 and 60 ml/min/1.73 m 2 or proteinuria >500 mg/d, from 11 large hospitals in India.…”