ASSESSING KIDNEY DISEASE BURDEN IN RURAL INDIA WITH SCREENING CAMPS

Introduction:

Chronic kidney disease (CKD) is becoming increasingly prevalent in the underdeveloped regions of the world and particularly in South Asia, where limited resources and low awareness contribute to late-stage diagnoses. While early CKD screening in high-income countries has proven effective, data from low-income countries remains scarce.

Methods:

This study employed the Kidney Early Evaluation Program (KEEP) screening model, developed by the National Kidney Foundation (NKF), to screen for CKD and its risk factors in rural South India. Funded by a US-based non-profit - Tamilnadu Foundation USA's SIGARAM project, screenings were conducted from 2018 to 2024 across four rural camps. The Centers for Disease Control (CDC) CKD risk score calculator was used to evaluate CKD risk. The screenings included health questionnaires, vital measurements, lab tests, and exit interviews with medical providers. Those with positive screenings were referred to local healthcare providers for follow-up.

Results:

Of the 431 patients screened, 358 were included in the analysis. Among these, 39.6% had diabetes, 31.6% had hypertension, 29.2% were using NSAIDs, and 12% had a history of kidney stones. Using the 2021 CKD-EPI creatinine equation, we found 2% of patients with a GFR <15, 13% with a GFR of 15-59, and 85% with a GFR over 60. Additionally, CKD risk assessment using the SCORED study equation revealed that 13% of patients had a high CKD risk (>30%), 72% had a moderate risk (1-30%), and 15% had a low risk (<1%). Notably, many patients were unaware of their diagnoses of diabetes and hypertension.

Conclusions:

The results demonstrate that a CKD screening program modeled on KEEP is reproducible in resource-limited settings. Although only a small number of CKD cases were identified, the program was successful in diagnosing many patients with diabetes and hypertension—top risk factors for CKD. These camps provided critical healthcare access, education, and awareness about non-communicable diseases in rural South India. Given the limited number of nephrologists and dialysis units in the region, prevention and education emerge as vital strategies to address the growing CKD burden.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.