A recent pilot study has revealed that chronic kidney disease (CKD) remains a major yet largely undetected health challenge in Andhra Pradesh, particularly among high-risk populations. Researchers used point-of-care diagnostic tests and digital health tools at local primary health centres (PHCs) to screen nearly 2,000 individuals across urban and rural regions.
The findings showed a strikingly high prevalence of CKD. The condition was detected in 57.5% of participants in urban areas and 61.8% in rural regions, resulting in an overall average prevalence of nearly 60% among the screened population.
Alarmingly Low Awareness Among Patients
Despite the high prevalence, awareness of CKD among patients was extremely limited. Only 1.4% of urban patients and 16.5% of rural patients knew they had the condition prior to the screening.
Consequently, more than 98% of urban patients and over 83% of rural patients remained unaware of their illness, even though many were at high or very high risk of developing serious complications.
Rural Patients Show More Advanced Disease
As reported by TOI, the study also revealed notable differences in disease severity between urban and rural populations. Advanced stages of CKD appeared more frequently in rural areas. Approximately 12.5% of rural patients were diagnosed with stage 4 CKD and 9.8% with stage 5, compared with 4.4% and 1.4% respectively in urban populations.
In addition, patterns of albuminuria—an indicator of kidney damage—varied between the two groups. Rural patients commonly presented with moderate albuminuria, whereas urban patients showed higher rates of severe albuminuria.
Differences in Comorbidities Between Urban and Rural Groups
Urban patients carried a heavier burden of associated conditions. Among the urban CKD group, 80.7% had diabetes and 78.4% had hypertension. In contrast, rural patients showed lower rates of these common risk factors.
Interestingly, nearly 48.4% of rural CKD patients had no identifiable comorbidities. This finding suggests that environmental factors or other unknown causes may contribute to the high prevalence of CKD in these regions.
Screening Conducted in High-Risk and Hotspot Areas
The researchers conducted screening among two distinct population groups. The first group included 843 high-risk individuals from urban PHCs in Guntur and Mangalagiri who already had non-communicable diseases such as diabetes or hypertension.
The second group consisted of 1,217 individuals from rural CKD hotspot regions, including Uddanam in Srikakulam district and A Konduru in Krishna district. These areas are known for a high prevalence of unexplained CKD and are characterised by challenging socioeconomic conditions.
Economic Barriers and Policy Gaps
The findings highlight several systemic challenges. CKD remains widespread but largely undiagnosed, even in rural hotspots where selective screening had been conducted previously.
Economic barriers further complicate early detection. Only about 15% of India’s population currently has health insurance coverage, while nearly 70% of healthcare expenses are paid out of pocket. As a result, routine laboratory tests required for CKD diagnosis remain unaffordable for many individuals.
Moreover, India’s national non-communicable disease (NCD) programme currently focuses on hypertension and diabetes but does not include CKD screening. This omission creates a significant gap in preventive healthcare efforts.
Digital Tools Enable Early Detection
The study demonstrated that point-of-care testing combined with digital technology can effectively support early detection of CKD at the primary care level.
According to the researchers, the integrated digital mobile platform allows trained non-specialised health workers to collect patient data and assist in disease diagnosis. This approach also facilitates the integration of kidney care into routine primary healthcare services.
The researchers emphasised the need for broader CKD screening among high-risk groups and timely referral to pre-dialysis nephrology care. Early intervention, they noted, has already been shown to reduce complication rates and prove cost-effective in managing the disease.
Research Collaboration and Publication
The study was conducted by Rama Krishna Chinta, Venkateswar Shri, Bogdan Milojkovic, Dennis Begos, Shyamala Kemisetti, Naresh Kumar Chintagunti, and Boris Bikbo, representing organisations involved in healthcare, digital technology, and analytical instruments.
The research has been published in Kidney International Reports, the official journal of the International Society of Nephrology.