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. 2019 Mar 7;9(3):e023353.
doi: 10.1136/bmjopen-2018-023353.

Prevalence of and risk factors for chronic kidney disease of unknown aetiology in India: secondary data analysis of three population-based cross-sectional studies

Cristina O'Callaghan-Gordo  1   2   3   4 , Roopa Shivashankar  5   6 , Shuchi Anand  7 , Shreeparna Ghosh  5 , Jason Glaser  4   8 , Ruby Gupta  5 , Kristina Jakobsson  9   10 , Dimple Kondal  5   6 , Anand Krishnan  11 , Sailesh Mohan  5 , Viswanathan Mohan  12   13 , Dorothea Nitsch  14 , Praveen P A  6   15 , Nikhil Tandon  15 , K M Venkat Narayan  16 , Neil Pearce  4   17 , Ben Caplin  18 , Dorairaj Prabhakaran  5   6
Affiliations

Prevalence of and risk factors for chronic kidney disease of unknown aetiology in India: secondary data analysis of three population-based cross-sectional studies

Cristina O'Callaghan-Gordo et al. BMJ Open. .

Erratum in

Abstract

Objectives: To assess whether chronic kidney disease of unknown aetiology (CKDu) is present in India and to identify risk factors for it using population-based data and standardised methods.

Design: Secondary data analysis of three population-based cross-sectional studies conducted between 2010 and 2014.

Setting: Urban and rural areas of Northern India (states of Delhi and Haryana) and Southern India (states of Tamil Nadu and Andhra Pradesh).

Participants: 12 500 individuals without diabetes, hypertension or heavy proteinuria.

Outcome measures: Mean estimated glomerular filtration rate (eGFR) and prevalence of eGFR below 60 mL/min per 1.73 m2 (eGFR <60) in individuals without diabetes, hypertension or heavy proteinuria (proxy definition of CKDu).

Results: The mean eGFR was 105.0±17.8 mL/min per 1.73 m2. The prevalence of eGFR <60 was 1.6% (95% CI=1.4 to 1.7), but this figure varied markedly between areas, being highest in rural areas of Southern Indian (4.8% (3.8 to 5.8)). In Northern India, older age was the only risk factor associated with lower mean eGFR and eGFR <60 (regression coefficient (95% CI)=-0.94 (0.97 to 0.91); OR (95% CI)=1.10 (1.08 to 1.11)). In Southern India, risk factors for lower mean eGFR and eGFR <60, respectively, were residence in a rural area (-7.78 (-8.69 to -6.86); 4.95 (2.61 to 9.39)), older age (-0.90 (-0.93 to -0.86); 1.06 (1.04 to 1.08)) and less education (-0.94 (-1.32 to -0.56); 0.67 (0.50 to 0.90) for each 5 years at school).

Conclusions: CKDu is present in India and is not confined to Central America and Sri Lanka. Identified risk factors are consistent with risk factors previously reported for CKDu in Central America and Sri Lanka.

Keywords: chronic renal failure; epidemiology; nephrology; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study flow chart. ACR, albumin:creatinine ratio; CARRS, Centre for Cardiometabolic Risk Reduction in South Asia; eGFR, estimated glomerular filtration rate; ICMR-CHD, Indian Council of Medical Research Coronary Heart Disease.
Figure 2
Figure 2
Prevalence ratio of estimated glomerular filtration rate <60 for rural versus urban residence in different age groups.
See this image and copyright information in PMC

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