Study to Test and Operationalize Preventive Approaches for CKD of Undetermined Etiology in Andhra Pradesh, India

Abstract Introduction High prevalence of chronic disease (CKD) not associated with known risk factors has been reported from coastal districts of Andhra Pradesh. The present study aims to ascertain the burden (prevalence and incidence) of CKD, their risk factor profile and the community perceptions about the disease in Uddanam. Methods Study participants will be sampled from the Uddanam area of Srikakulam district of Andhra Pradesh using multi-stage cluster random sampling. Information will be collected on the demographic profile, occupational history and presence of conventional as well as non-conventional risk factors. GFR will be estimated using CKD-EPI equation and proteinuria will be measured. All abnormal values will be confirmed by repeat testing after 3 months. Cases of CKD not associated with identified etiologies will be identified. Biospecimens will be stored to explore future hypotheses. The entire cohort will be followed up for every 6 months to determine incidence of CKD and identify risk factors for decline in kidney function. Qualitative studies will be done to understand the community perceptions and expectations with respect to the interventions. Implications CKD is an important public health challenge in low and middle income countries. This study will establish the prevalence and determine the incidence of CKD not associated with known risk factors in a reported high burden region and provide insights to help design targeted health systems responses. The findings will contribute to the policy development to tackle CKD in the region and permit international comparisons with other regions with similar high prevalence.