1. ¹Department of Nephrology, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
2. ²Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence: V Jha, Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. E-mail: vjha@pginephro.org

Received 24 July 2006; Revised 5 September 2006; Accepted 12 September 2006; Published online 25 October 2006.

Abstract

Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are emerging public health problems in developing countries, and need changes in health-care policy. ESRD incidence data are not available from large parts of the developing world including South Asia. We report the ESRD incidence in a large urban population in India. ESRD incidence was estimated for four consecutive calendar years (2002–2005) among 572 029 subjects residing in 36 of the 56 wards of the city of Bhopal. These subjects are beneficiaries of free health care in a hospital established after the 1984 Union Carbide Industrial Accident. Crude and age-adjusted incidence rates were calculated. A total of 346 new ESRD patients were diagnosed during the study period; 86 in 2002, 82 in 2003, 85 in 2004, and 93 in 2005. Average crude and age-adjusted incidence rates were 151 and 232 per million population, respectively. The mean age was 47 years, and 58% were males. Diabetic nephropathy was the commonest (44%) cause of ESRD. This study provides the first population-based ESRD incidence data from India and reveals it to be higher than previously estimated. Diabetic nephropathy is the leading cause of ESRD. Changes are required in health-care policy for optimal care of CKD patients and efficient resource utilization for management of those with ESRD.