New Delhi: The prevalence of impaired kidney function (IKF) among Indian kids and adolescents, at 4.9 percent, could be multiple times higher than the global average, the first nationwide estimate of the condition based on the Comprehensive National Nutrition Survey (CNNS) has suggested.
This prevalence rate translates to about 49,000 per million kids and teenagers living with compromised kidney function in the country.
The analysis carried out by researchers at the International Institute for Population Sciences (Mumbai), The George Institute of Public Health (Delhi) and some other institutes has come out in the journal Springer Nature this week.
It showed that rural residence, non-reserved social caste, less educated mothers, children with severe stunting or being overweight or obese, and residence in Southern India among others were the predictors of IKF, which when persistent for three months or more is called chronic kidney disease (CKD), a pressing public health concern.
“The prevalence of IKF among children and adolescents in India is high compared to available global estimates,” the researchers have noted.
In the absence of repeated eGFR (estimated glomerular filtration rate)-based estimates, these nationally representative estimates are intriguing and call for further assessment of socio-demographic disparities, genetics, and risk behaviors to have better clinical insights and public health preparedness, they also cautioned.
Dr Vivekanand Jha, executive director, The George Institute for Global Health and professor and chair of global kidney health with Imperial College, London and a co-author of the study, told ThePrint that the findings are important as they suggest an alarmingly high burden of IFK among Indian children, on the lines of adults.
“The global average of IKF among those under 18 years is 1-2 percent. Now, this new analysis has shown that this burden is unusually high among Indian kids and adolescents, even though the data did not allow us to fully understand the reasons behind this,” Jha said.
He pointed out that the prevalence of CKD in India is also way higher, about 20-22 percent, as opposed to the world average of 7-8 percent.
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The finer details
The secondary data analysis used a nationally representative dataset generated from the CNNS carried out by the Union health ministry between 2016 and 2018.
The CNNS was based on selecting a representative sample of over 1.2 lakh individuals aged 0–19 across 30 states and information on participants’ nutritional status, anthropometric markers, food intake, and micronutrient levels was collected.
The researchers noted that due to a growing risk of non-communicable diseases in India, the renal function testing was also included and it covered 5 to 9 years and 10–19 years age groups.
The analysis showed that the IKF prevalence was 4.9 percent overall, and 5.6 percent, 3.4 percent and 5.2 percent in the 5–9, 10–14, and 15–19 year age groups, respectively.
In 5–9 years, prevalence varied significantly across all the studied independent variables except gender, while in 10–14 years, the differences were non-significant across gender, attending schools, mother’s education, and body mass index (BMI)-for-age.
In the 15–19 years, it varied significantly across gender, social caste, wealth index, mother’s education, type of diet, height-for-age, BMI-for-age, and regions of India.
Also, the highest prevalence was observed in Andhra Pradesh, followed by Telangana and West Bengal, while the prevalence was lowest in Tamil Nadu, Chhattisgarh, Rajasthan and Kerala.
This study has a few policy implications, noted the study authors saying that despite the documented high and increasing prevalence, CKD has not received priority in public health programs globally, including in India.
“Further, it has primarily been considered a disease of the adult population, but the results emerging from the current study demand its prioritization in the pediatric population as well,” they pointed out.
(Edited by Tony Rai)
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