Experience with a program for prevention of chronic renal failure in India

BACKGROUND: For the past eight years, the Kidney Help Trust of Chennai has run a program to prevent chronic renal failure by regular screening of an entire population of 25,000, and treatment of diabetes and hypertension with the cheapest available drugs. The total cost amounts to 25 cents per capita of the study population. METHODS: The program has recently been expanded to cover the adjacent area with a population of 21,500. Both the original population and the new population are being surveyed. Persons at risk of renal failure are identified as reported earlier, and glomerular filtration rate (GFR) is estimated by the MDRD formula. The survey is as yet incomplete. Six thousand one hundred people in the new area, and 20,986 in the old, have been studied so far, and the numbers and percentage of those with GFR below normal have been compared. RESULTS: The prevalence of impaired renal function (GFR below 80 mL/min) in the original population is 8.6 per thousand, and in the new population is 13.9 per thousand (P= 0.005, RR 1.61, CI 1.15-2.24). CONCLUSION: This model provides an effective method for prevention of chronic renal failure at the community level.