The impact of cultural, socioeconomic, behavioral and health disadvantages on the incidence and severity of chronic kidney disease:A case- control study of Uddanam region of Andhra Pradesh, India.

AbstractBackgroundPresently both developed and developing countries are suffering from chronic kidney disease (CKD) worldwide. CKD with unknown etiology rapidly and silently affects people without any prior symptoms. Loss of renal function due to progressive loss of glomerular filtration rate (GFR) and co morbidities is an important factor leading to adult mortality. This study aimed at to investigate the impact of cultural, socioeconomic, behavioral and health factors on chronic kidney disease prevalence and severity in Kaviti and Kanchili Mandals within the Uddanam region of North Coastal Andhra Pradesh, India.MethodsA case‒control study was conducted on 2806 participants (1001 CKD patients and 1001 healthy controls in Kaviti Mandal and 402 CKD patients and 402 healthy controls in Kanchili mandal of the Uddanam region. Logistic and multiple regression analyses and independent t-tests were applied to measure the association between selected parameters such as average spending per month on transport, diagnosis and medicine juxtaposed to various parameters of CKD and normal families.ResultsIn the Uddanam region, the patient’s average spending costs per month on transport to the hospital, diagnosis, and medicine were 919/-, 1225/-, and 2076/-, respectively, and stage 4 and 5 patients were spent more money for treatment of the disease. The logistic regression analysis revealed that the people in the open category(OROC/SC&ST= 5.132, 2.513-10.48), lower economic category (ORLOWER/UPPER= 7.011, 1.482-33.17), farmers (ORFARMER/ANY OTHER=1.620 (1.226-2.14), those in the education system primary education group (ORPRIMARY/COLLEGEANDABOVE=3.246,9.598-25.766), hypertensive individuals (ORYES/NO= 5.088,4.2-6.16) and people who had other ailments (ORYES/NO= 3.714, 2.992-4.61) had a significant risk association with CKDu.ConclusionThe present study revealed that living in rural areas and belonging to lower socioeconomic status per se play a significant role in the causation of chronic kidney disease and that these CKD patients spend more money to treat the disease as it progresses. The improvement of health care facilities especially specialties dealing with kidney diseases and creating awareness of CKD risk factors are needed.