CKD is the Major Cause of Death in Uddanam: A Population-Representative Study Using Smart Verbal Autopsy

Balaji Gummidi; Vaishali Gautam; Renu John; Rohina Joshi; Oommen John; Vivekanand Jha

doi:10.1016/j.ekir.2023.10.026

CKD is the Major Cause of Death in Uddanam: A Population-Representative Study Using Smart Verbal Autopsy

Kidney Int Rep. 2023 Oct 31;9(1):108-113. doi: 10.1016/j.ekir.2023.10.026. eCollection 2024 Jan.

Authors

Balaji Gummidi¹, Vaishali Gautam¹, Renu John¹, Rohina Joshi^{1

2}, Oommen John^{1

3}, Vivekanand Jha^{1

3

4

5}

Affiliations

¹ The George Institute for Global Health India, UNSW, New Delhi, India.
² School of Population Health, University of New South Wales, Sydney, Australia.
³ Manipal Academy of Higher Education, Manipal, India.
⁴ Faculty of Medicine, Imperial College London, London, UK.
⁵ Faculty of Medicine, University of New South Wales, Sydney.

Abstract

Introduction: Uddanam is an agricultural area with a high burden of chronic kidney disease of unknown etiology (CKDu). Despite reports of many deaths due to CKD in the lay press, the exact contribution of CKD to deaths remains uncertain because most deaths occur outside medical care.

Methods: We used SmartVA automated verbal autopsy tool to ascertain the cause-specific mortality fractions among a 2419 subject-strong general population cohort of adult subjects in Uddanam between 2018 and 2022. Verbal autopsy interviews were conducted twice with the family members of the deceased.

Results: A total of 133 deaths were recorded, giving a crude death rate of 5.5%, 10 times higher than that recorded in national surveys. CKD was responsible for 45% of all deaths, followed by ischemic heart disease (15%) and respiratory disease (6%).

Conclusion: This study confirms CKD as the leading cause of mortality in this high CKD burden area and provides crucial data for public health decision-making and resource allocation.

Keywords: CKD of unknown etiology; SmartVA; cause of death; chronic kidney disease; uddanam nephropathy; verbal autopsy.