Related Topics: Public Health, Science &Technology
Rising burden of CKD in Kerala and its economic implications on the individuals and the health system seemed to have escaped the attention of policy makers, primarily because of the lack of robust data on the disease in the State.
What is CKD?
- It is a condition characterized by a gradual loss of kidney function over time.
- The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time.
CKD of unknown aetiology (CKDu)
- Over the past five years, there is a significant increase in young patients with CKD of undetermined cause — a fairly new entity, ‘CKD of unknown aetiology (CKDu)’.
- It was first reported in 1990s in Central America, where an unusually large number of agricultural workers exposed to very hot and humid weather conditions and dehydration were succumbing to renal failure.
- It is emerging as a global problem with similar disease patterns being reported from select geographical regions in tropical nations, including Sri Lanka and India.
- The ageing population, the high prevalence of diabetes and hypertension on the one side and the poor control of these conditions are primarily contributing to the rising burden of the disease.
- Exposure to agrochemicals, heavy metals, and infectious agents, as well as genetic factors and risk factors related to poverty, malnutrition, and other social determinants of health may also contribute to the disease.
CKDu & Climate change
- There is an unavoidable link between CKDu, heat exposure, dehydration, and other environmental stressors.
- All geographical regions where CKDu has been reported have undergone substantial climatic and environmental changes in recent times.
- The fact that CKDu could be a form of heat-stress nephropathy, possibly because of the rapidly changing global temperature and environment conditions, is the focus of the recent issue of New England Journal of Medicine (NEJM).
In India, deaths due to renal failure constituted 2.9% of all deaths in 2010-13 among 15-69 year-olds, an increase from 2.1 % in 2001-03 ( Lancet Global Health, January 2017).
Guidelines by World Health Organisation
- There is a need for targeted screening programme to identify individuals at high risk of developing CKD and treating them early.
- Epidemiological studies using standardised definitions of conditions in community and institutional settings are essential to achieving early detection of the disease, appropriate interventions, and improved patient outcomes.
- Better information is needed on who should be screened for kidney disease.
- A proper data system on CKD, on the lines of the United States Renal Data System, for analysing CKD prevalence, trends in mortality rate, and patient demographics should be developed.