Four years back, the Regional Medical Research Laboratory in Bhubaneswar, a top facility under the Indian Council of Medical Research, carried out a study in Cuttack district’s Narasinghpur block in Odisha to understand the consistent pattern of chronic kidney diseases (CKD) burden among the local population.
From a sample of 2,978 people who were screened, at least 14 percent were diagnosed with kidney disease. This belt in Odisha by the Mahanadi river has had a high incidence of CKD for more than a decade. However, what has now run the alarm bells is that neighbouring Dhenkanal district could be emerging as another hotspot.
The study looked at over 4,000 kidney patients from the last seven years to find that half of them belonged to Dhenkanal district alone. In terms of the non-communicable disease burden, CKD has been a challenge India has grappled with.
According to a reply given in parliament, the country’s CKD burden increased 5.6 percent between 1990 and 2017. A Lancet study in 2020 suggested that out of the 697 million CKD cases across the globe in 2017, India alone accounted for 115 million, next only to China.
This is precisely why the latest reports on emerging hotspots raise concern and the Dhenkanal case must be seen as a red flag. It is important to understand that the clinical study came from a hospital setting, which points at a bias since incidence among the diseased segment is always higher.
What, however, is alarming is that doctors conducting camps in villages have also reported a significant spurt in kidney ailments and its clustering in the local populace. This calls for a study in the region to understand the actual burden and the reasons. A Regional Medical Research Centre study in the Narasinghpur and Badamba blocks had revealed that over 75 percent of CKD patients did not have diabetes or hypertension, and pointed at either genetic or environmental causes.
Curiously, the two CKD hotspots have one common thread—rivers. If it is Mahanadi for Cuttack, Dhenkanal has Brahmani river, whose basin is dotted with a large number of polluting industries. It is imperative that the Odisha government commissions a population-based study and digs deep into the growing burden of kidney disease before its tentacles spread far.