Chronic kidney disease is the leading cause of death in Andhra Pradesh's Uddanam region: GI Report

Visakhapatnam/ New Delhi: Chronic Kidney Disease (CKD), which is a gradual loss of kidney function, is the leading cause of death in the Uddanam region in the coastal district of Srikakulam of Andhra Pradesh, according to a new study report released by The George Institute for Global Health on Wednesday.

Established in Sydney, with major standalone centres in China, India, and the UK, the George Institute, an independent medical research institute aiming to improve the health of millions of people worldwide by generating effective, evidence-based and affordable solutions to the world’s biggest health challenges.

The age and sex-adjusted prevalence of CKD in this area is estimated at 18-22%, 2.5 to 3.3 times higher than the population prevalence of CKD reported from other regions of India, the report revealed.

Previous reports in the lay press have highlighted a large burden of deaths due to CKD in Uddanam, but to date, there has been no study with formal ascertainment of causes of death in the region.

A population-representative study conducted by a group of researchers from The George Institute has filled this gap and was published on October 31, 2023 in the Kidney International Report Journal.

The study used the Smart Verbal Autopsy (SmartVA) tool, that uses a computerized algorithm to interpret data from interviews with surviving family members or caregivers of deceased individuals.

The tool has been validated by the Population Health Metrics and Research Consortium under various settings. It uses a predefined set of questions to collect data regarding the indications, symptoms, and cause of death.

The study used the adult deaths module of SmartVA, offering a systematic and automated approach to identify the probable cause of death for individuals aged 12 and older. The tool facilitated the analysis of the cause-specific death fractions using a general population sample of 2,419 individuals in Uddanam from 2018 to 2022.

The study demonstrates the extent to which CKD impacts the people of the Uddanam region in Andhra Pradesh.

The key findings of the study are – CKD constituted for a significant 45% of all recorded fatalities in the Uddanam region, making it the leading cause of mortality.

The study also discovered an exceptionally high crude death rate of 5.5% in Uddanam, which is ten times higher than the mortality rate reported in national surveys. The significant disparities in death rates demonstrate the severity of the local health problem. The higher death rate among adults is 20 years of age and older suggests a major problem.

The study also revealed that CKD is the leading cause of mortality in Uddanam and that it also poses a considerable health risk to the community. The finding has important implications for resource allocation and public health policy.

The research proposed using automated technologies such as Smart Verbal Autopsy (SmartVA) to increase the standard of death reporting in rural areas.

By using this technique in the study, the researchers were able to obtain precise cause-of-death information and minimize reporting uncertainty around mortality.

The study emphasized the importance of developing targeted methods for early detection, diagnosis, and treatment and urges the mobilization of resources and public health initiatives to combat CKD in the region.

The study also underlined the validity and potential for the use of the SmartVA tool in community settings by highlighting its effectiveness to collect important cause-specific death information in Uddanam, which can help to improve data quality for effective public health interventions and policy-making.

According to Professor Vivekanand Jha, Executive Director, the George Institute for Global Health, India, and the lead researcher of the study, “The research has revealed that chronic illness is not only a health problem but also the main cause of death in Uddanam.

To prevent and manage CKD and increase community awareness of early diagnosis and treatment, we are working closely with the district and state health authorities to develop and implement region-specific policies that will improve the outcomes of these patients. The government has increased access to diagnosis and evidence-based treatment for kidney diseases which will likely translate into improved outcomes”.

Other members involved in the study including Dr Balaji Gummidi, Dr. Vaishali Gautam, Dr Renu John, Dr. Rohina Joshi, and Dr Oommen John. (UNI)