Browsing by Author "Gopesh K. Modi"

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Epidemiology and risk factors of chronic kidney disease in India - Results from the SEEK (Screening and Early Evaluation of Kidney Disease) study
(2013) Ajay K. Singh; Youssef M.K. Farag; Bharati V. Mittal; Kuyilan Karai Subramanian; Sai Ram Keithi Reddy; Vidya N. Acharya; Alan F. Almeida; Anil Channakeshavamurthy; H Sudarshan Ballal; P. Gaccione; Rajan Issacs; Sanjiv Jasuja; Ashok L. Kirpalani; Vijay Kher; Gopesh K. Modi; Georgy Nainan; Jai Prakash; Devinder Singh Rana; Rajanna Sreedhara; Dilip Kumar Sinha; Shah Bharat V.; Sham Sunder; Raj K. Sharma; Sridevi Seetharam; Tatapudi Ravi Raju; Mohan M. Rajapurkar
Background: There is a rising incidence of chronic kidney disease that is likely to pose major problems for both healthcare and the economy in future years. In India, it has been recently estimated that the age-adjusted incidence rate of ESRD to be 229 per million population (pmp), and >100,000 new patients enter renal replacement programs annually. Methods. We cross-sectionally screened 6120 Indian subjects from 13 academic and private medical centers all over India. We obtained personal and medical history data through a specifically designed questionnaire. Blood and urine samples were collected. Results: The total cohort included in this analysis is 5588 subjects. The mean ± SD age of all participants was 45.22 ± 15.2 years (range 18-98 years) and 55.1% of them were males and 44.9% were females. The overall prevalence of CKD in the SEEK-India cohort was 17.2% with a mean eGFR of 84.27 ± 76.46 versus 116.94 ± 44.65 mL/min/1.73 m2 in non-CKD group while 79.5% in the CKD group had proteinuria. Prevalence of CKD stages 1, 2, 3, 4 and 5 was 7%, 4.3%, 4.3%, 0.8% and 0.8%, respectively. Conclusion: The prevalence of CKD was observed to be 17.2% with ∼6% have CKD stage 3 or worse. CKD risk factors were similar to those reported in earlier studies.It should be stressed to all primary care physicians taking care of hypertensive and diabetic patients to screen for early kidney damage. Early intervention may retard the progression of kidney disease. Planning for the preventive health policies and allocation of more resources for the treatment of CKD/ESRD patients are imperative in India. © 2013 Singh et al.; licensee BioMed Central Ltd.
Indian chronic kidney disease study: Design and methods
(Blackwell Publishing, 2017) Vivek Kumar; Ashok Kumar Yadav; Sishir Gang; Oommen John; Gopesh K. Modi; Jai Prakash Ojha; Rajendra Pandey; Sreejith Parameswaran; Narayan Prasad; Manisha Sahay; Santosh Varughese; Seema Baid-Agarwal; Vivekanand Jha
Aim: The rate and factors that influence progression of chronic kidney disease (CKD) in developing countries like India are unknown. A pan-country prospective, observational cohort study is needed to address these knowledge gaps. Methods: The Indian Chronic Kidney Disease (ICKD) study will be a cohort study of approximately 5000 patients with mild to moderate CKD presenting to centres that represent different geographical regions in India. Time to 50% decline in baseline estimated glomerular filtration rate, need of renal replacement therapy or any new cardiovascular disease (CVD) event or death from CVD are the primary end points. Value of Study: This study will provide the opportunity to determine risk factors for CKD progression and development of CVD in Indian subjects and perform international comparisons to determine ethnic and geographical differences. A bio-repository will provide a chance to discover biomarkers and explore genetic risk factors. © 2016 Asian Pacific Society of Nephrology
Nonmedical factors and health-related quality of life in CKD in India
(American Society of Nephrology, 2020) Gopesh K. Modi; Ashok K. Yadav; Arpita Ghosh; Kajal Kamboj; Prabhjot Kaur; Vivek Kumar; Shobhit Bhansali; Narayan Prasad; Manisha Sahay; Sreejith Parameswaran; Santosh Varughese; Sishir Gang; Shivendra Singh; Dipankar Sircar; Natarajan Gopalakrishnan; Ajay Jaryal; Sanjay Vikrant; Seema Baid Agarwal; Vivekanand Jha
Background and objectives Patient-reported outcomes have gained prominence in the management of chronic noncommunicable diseases. Measurement of health-related quality of life is being increasingly incorporated into medical decision making and health care delivery processes. Design, setting, participants, & measurements The Indian Chronic Kidney Disease Study is a prospective cohort of participants with mild to moderate CKD. Baseline health-related quality of life scores, determined by the standardized Kidney Disease Quality of Life 36 item instrument, are presented for the inception cohort (n52919). Scores are presented on five subscales: mental component summary, physical component summary, burden, effect of kidney disease, and symptom and problems; each is scored 0–100. The associations of socioeconomic and clinical parameters with the five subscale scores and lower quality of life (defined as subscale score <1 SD of the sample mean) were examined. The main socioeconomic factors studied were sex, education, occupation, and income. The key medical factors studied were age, eGFR, diabetes, hypertension, and albuminuria. Results The mean (SD) subscale scores were physical component summary score, 4369; mental component summary score, 48610; burden, 61633; effects, 87613; and symptoms, 90620. Among the socioeconomic variables, women, lower education, and lower income were negatively associated with reduced scores across all subscales. For instance, the respective b-coefficients (SD) for association with the physical component summary subscale were 22.6 (23.4 to 21.8), 21.5 (22.2 to 20.7), and 21.6 (22.7 to 20.5). Medical factors had inconsistent or no association with subscale scores. The quality of life scores also displayed regional variations. Conclusions In this first of its kind analysis from India, predominantly socioeconomic factors were associated with quality of life scores in patients with CKD. © 2020 by the American Society of Nephrology.
Prescription Practices in Patients With Mild to Moderate CKD in India
(Elsevier Inc., 2021) Narayan Prasad; Ashok Kumar Yadav; Monica Kundu; Jasmin Sethi; Ajay Jaryal; Dipankar Sircar; Gopesh K. Modi; Kajal Kamboj; Manisha Sahay; Natarajan Gopalakrishnan; Prabhjot Kaur; Sanjay Vikrant; Santosh Varughese; Seema Baid-Agrawal; Shivendra Singh; Sishir Gang; Sreejith Parameswaran; Vivek Kumar; Arpita Ghosh; Vivekanand Jha
Introduction: Patients with chronic kidney disease (CKD) require multiple medications. There is no information on prescription patterns or the use of evidence-based therapies for management of CKD from low-middle-income countries. Using baseline data from the Indian CKD (ICKD) cohort, we describe the drug prescription practices in patients with mild to moderate CKD. Methods: The ICKD study is a prospective, observational cohort study of mild to moderate kidney disease across 11 centers in India. We analyzed all the prescriptions captured at enrollment in the ICKD study. Drugs were categorized into 11 different groups. We provide descriptive data on prescription details and evaluate the appropriateness of medication use. Results: Complete prescription data were available in 3966 out of 4056 (97.8%) subjects enrolled in the ICKD database. Most patients had stage 3 CKD, 24.9% had diabetic kidney disease, 87% had hypertension, and 25.5% had moderate to severe proteinuria. Renin-angiotensin-aldosterone system blockers were prescribed in less than half (47.9%) and in 58.8% of patients with proteinuric CKD. Metformin was prescribed in 25.7% of diabetic subjects with CKD. Only 40.4% of patients were taking statins; 31.1% and 2.8% subjects with anemia were receiving iron and erythropoiesis-stimulating agents, respectively. Conclusion: This study highlights the missed opportunities for improving outcomes through appropriate prescriptions of drugs in patients with CKD. There is need for dissemination of evidence-based guidelines and institution of sustainable implementation practices for improving the overall health of patients with CKD. © 2021 International Society of Nephrology
The Indian Chronic Kidney Disease (ICKD) study: baseline characteristics
(Oxford University Press, 2022) Vivek Kumar; Ashok Kumar Yadav; Jasmine Sethi; Arpita Ghosh; Manisha Sahay; Narayan Prasad; Santosh Varughese; Sreejith Parameswaran; Natarajan Gopalakrishnan; Prabhjot Kaur; Gopesh K. Modi; Kajal Kamboj; Monica Kundu; Vivek Sood; Neeraj Inamdar; Ajay Jaryal; Sanjay Vikrant; Saurabh Nayak; Shivendra Singh; Sishir Gang; Seema Baid-Agrawal; Vivekanand Jha
Background: Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. There is a lack of information on epidemiology and progression of CKD in low-middle income countries. The Indian Chronic Kidney Disease (ICKD) study aims to identify factors that associate with CKD progression, and development of kidney failure and cardiovascular disease (CVD) in Indian patients with CKD. Methods: ICKD study is prospective, multicentric cohort study enrolling patients with estimated glomerular filtration rate (eGFR) 15-60 mL/min/1.73 m2, or >60 mL/min/1.73 m2 with proteinuria. Clinical details and biological samples are collected at annual visits. We analysed the baseline characteristics including socio-demographic details, risk factors, disease characteristics and laboratory measurements. In addition, we compared characteristics between urban and rural participants. Results: A total of 4056 patients have been enrolled up to 31 March 2020. The mean ± SD age was 50.3 ± 11.8 years, 67.2% were males, two-thirds of patients lived in rural areas and the median eGFR was 40 mL/min/1.73 m2. About 87% were hypertensive, 37% had diabetes, 22% had CVD, 6.7% had past history of acute kidney injury and 23% reported prior use of alternative drugs. Diabetic kidney disease, chronic interstitial nephritis (CIN) and CKD-cause unknown (CKDu) were the leading causes. Rural participants had more occupational exposure and tobacco use but lower educational status and income. CIN and unknown categories were leading causes in rural participants. Conclusions: The ICKD study is the only large cohort study of patients with mild-to-moderate CKD in a lower middle income country. Baseline characteristics of study population reveal differences as compared with other cohorts from high-income countries. © 2021 The Author(s) 2021.