Demographic profile, spectrum, awareness, and cost of renal replacement therapy of chronic kidney disease patients in a public tertiary care center in Rajasthan, India

Abstract

Chronic kidney disease (CKD) is widely recognized as the leading cause of death worldwide. Diabetes and hypertension are common risk factors. This is the only study on CKD from Rajasthan that highlights basic CKD profiles in patients attending public tertiary care centers. This observation study included diagnosed cases of CKD attending nephrology outpatient department (OPD) from January to December 2020. Data regarding the cause of CKD, its stage, mode of renal replacement therapy (RRT), and direct cost of medication were collected. The state runs various schemes, including free dialysis facilities for all, below-poverty level cards (below poverty line [BPL] cards, which had complete free treatment), and state health cards Bhamasha Swasthya Bima Yojana (BSSY) under the government scheme. A total of 252 patients were included in the study. Patients on dialysis were highest, followed by stage V and stage IV CKD, representing 33.73%, 18.65%, and 17.86%, respectively. Hypertension was the predominant cause of CKD, representing 29.37% and CKD (u) prevalence in our study was 14.68%. The direct cost of treatment at CKD stages I, II, III, IV, and V were Rs. 520 ($6.93), Rs. 2435.71 ($32.48), Rs. 3400 ($45.33), Rs. 3405.57 ($45.41), and Rs. 4815.97 ($64.21) per month, respectively. The monthly medicine cost of treatment on hemodialysis was Rs. 6730.60 ($89.74), Rs. 30,278 ($403.71) on peritoneal dialysis, and Rs. 5021.74 ($66.96) on renal transplant. BPL card holders were 8.33%, 39.68% had BSSY card, 16.27% had Insurance, and around one-third (35.71%) were without support. Age, socioeconomic status, and geographical location affect CKD etiology. The accessible dialysis facility, insurance, and government policies affect the selection of the RRT.