Preventable factors contributing to increased rates of chronic kidney disease in rural India

Abstract

# Background Chronic kidney disease (CKD) is disproportionately more prevalent in rural and underserved areas globally, and the epidemiological factors contributing to this phenomenon are poorly understood. Here, we aim to identify several preventable factors contributing towards CKD in the city of Phalodi, a rural city located in the Indian state of Rajasthan. # Methods The qualitative and quantitative data obtained in this study comes from interviews with doctors, nurses, hospital administrators, and patients at the dialysis clinic in Phalodi. This region was selected because of its known increased prevalence of CKD, and its long-standing relation with Discovering Dialysis. # Results Several preventable factors were identified as contributors towards the increased prevalence of CKD: 1) Nimesulide abuse is fairly common in rural areas because it is affordable and effective, but it is highly nephrotoxic and hepatotoxic; 2) Kidney stones caused by the quantity and quality of rural water contribute towards both nimesulide abuse and CKD; 3) Lack of accessibility to healthcare for preventative measures and disease management exacerbate the severity of kidney disease; 4) Lack of transportation to dialysis centers limits the number of patients that can afford to receive dialysis treatment. # Conclusions This study demonstrates that several factors can be targeted to reduce the prevalence of CKD in rural India. Namely, legislation should focus on reducing nimesulide use, providing access to clean and available water, and increasing transportation to medical centers that can provide preventative care.