Correlates of Chronic Kidney Disease in India
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MEDICINE
Correlates of Chronic Kidney Disease in India Manas Pratim Roy 1 Accepted: 21 September 2020 # Springer Nature Switzerland AG 2020
Abstract Chronic kidney disease (CKD) is one of the major non-communicable diseases in India, yet there is a lack of nationally representative studies. The present study aimed to correlate certain demographic factors like tobacco use, alcohol use, the use of clean fuel, economic condition, obesity, and diabetes with CKD burden. National Family Health Survey 4 (2015–2016), Global Adult Tobacco Survey 2: India 2016–2017, and India: Health of the Nation’s States were used as data sources. Spearman correlation coefficient, scatter plot, and multivariate linear regression were used for analysis, considering state as a unit. Obesity and diabetes were significantly correlated with CKD burden (r = 0.452, p = 0.012 and r = 0.789, p = 0.000, respectively). Even after multivariate regression, they were found significant predictors for CKD burden. For reducing the burden of CKD, emphasis should be given to early diagnosis and management of diabetes and lifestyle modification. Keywords Chronic kidney disease . Diabetes . India . Obesity
Introduction Chronic kidney disease (CKD), characterized by progressive loss of kidney function, is a major public health problem in India and yet to get due attention, as evident from the lack of large-scale study in the country. Like other non-communicable diseases (NCDs), it is affecting every population to the extent of an epidemic. Globally, an estimated amount of over $1 trillion is spent worldwide on end-stage renal disease (ESRD) care [1]. An estimated 1.2 million people died from kidney failure in 2015 [2]. In the USA, up to 11% of people have some degree of CKD [3]. In China, the prevalence is estimated to the tune of 2–3% [4]. It is the ninth common cause of mortality, with a death rate of 18/ 100,000 population and responsible for 1.6% of disabilityadjusted life years (DALY) in India [5]. Between 1990 and 2016, deaths due to CKD have increased by 32.7% [6]. Regional studies found out the prevalence of CKD and ESRD as 0.79 and 0.015%, respectively [7, 8]. Another multi-centric study found the prevalence of CKD as high as 17.2%, with 6% having CKD stage 3 or above [9]. Several studies pointed out
This article is part of the Topical Collection on Medicine * Manas Pratim Roy [email protected] 1
Department of Pediatrics, Safdarjung Hospital, New Delhi 110029, India
diabetes and hypertension as the common causes of CKD [8, 10, 11]. Obesity has been implicated as an independent predictor for CKD [12]. Emerging evidence suggests the relationship of CKD with air pollution also [13]. Among social determinants, education plays an important role, as evident from the fact that 37.6% of CKD patients had an education level less than high school [9]. Higher morbidity and mortality were also noted in lower socioeconomic strata [14]. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) has brough
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