POS-333 THE INDIAN CHRONIC KIDNEY DISEASE STUDY: DETAILED DESCRIPTION OF BASELINE CHARACTERISTICS

Abstract

The Indian Chronic Kidney Disease (ICKD) study is an ongoing, nationwide, multi-centric prospective cohort study recruiting participants with mild to moderate CKD that aims to identify risk factors for CKD development and progression and implement effective therapies. Here, we report the baseline socio demographic, etiology of CKD, risk factors and laboratory parameters in the inception cohort. Patients with confirmed CKD between 18-70 years of age and estimated glomerular filtration rate (eGFR) of 15-60ml/min/1.73m2 or eGFR >60ml/min/1.73m2 and proteinuria/albuminuria with stable clinical course for at least 3 months have been recruited. Organ transplant recipients, those with malignancy for last 2 years, non-Indian ethnicity, pregnancy in case of females, on immunosuppressive therapy, life expectancy <1 year and with poor functional status are excluded. Socio-demographic details, history related to kidney diseases, traditional and indigenous risk factors, CVD and other co-morbidities are recorded. Blood and urine samples are being collected at baseline and annually. Primary outcome of the study is time to ESRD/RRT, 50% decline in eGFR and any new cardiovascular event Total 4056 CKD subjects has been enrolled. The mean age of the cohort was 50.3 +/-11.8 years with 67.2% males. Median eGFR was 40.5 ml/min/1.73m2. Diabetes (24.9%) was major cause of kidney disease followed by chronic interstitial nephritis (23.2%) and glomerulonephritis (14.7%). About 19.5 % of the subjects had CKD of unknown etiology. 27% of subjects were illiterate and 66% were rural residents. 30 % subjects were on vegetarian diet and half of cohort subjects were engaged in hazardous occupations. Median annual household income of ICKD cohort was USD 1680 with annual medical cost of USD 285. Only 32 % subject have medical insurance. Around 11% faced financial constrain for accessing healthcare. One third of female subjects had history of adverse pregnancy outcome. A majority of subjects had a history of hypertension (71%), 35.1% had diabetes, 15.5 % subjects had history of cardiovascular disease. History of alternative drug and NSAID use were reported in 22.9% and 15.6% of participants respectively. Acute kidney injury episode preceding CKD was documented in 6.68 % of the cohort subjects. This is the first CKD cohort in a low/middle income country. Our cohort was younger by a decade with a considerable higher representation of males than other cohort such as GCKD, CKD-JAC and the CRIC cohorts. Prevalence of hypertension and diabetes in our cohort was 71% and 35% respectively which was lower than that of CRIC and CKD-JAC cohort. One principal distinction from other cohorts is the identification of CKD of undetermined etiology as the cause of CKD in 19.5% of our cohort. The understanding of CKD risk factors in a developing country can be availed to target cost effective screening for CKD in at risk population