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Introduction
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Introduction
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Objectives …
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Non-communicable diseases (NCDs) are the leading cause of death throughout the
globe and is one of the major health challenges of the 21st century (WHO, 2018). According
to World Health Organization (WHO), NCDs are responsible for 71% (41 million of the 57
million) of deaths occurred around the world. Chronic NCDs are not transmitted directly
from one person to another, and they take long duration to develop as well as to show the
symptoms. The premature mortality and morbidity due to NCDs have major impact on
health-care costs, productivity and growth (Couser et al., 2011). The major NCDs with
highest number of deaths mainly includes cardiovascular diseases, cancers, respiratory
disorders and diabetes; while it also includes various other health problems such as hepatic,
renal, gastrointestinal, endocrine, hematological, neurological, dermatological, genetic and
mental disorders as well as disabilities (Habib and Saha, 2010; WHO, 2018; Budreviciute et
al., 2020; Wang and Wang, 2020).
Non-communicable diseases are long duration illnesses which targets men, women
and children of all income categories (National Health Mission, 2018). The progression of
various NCDs is slow to rapid based on types of diseases and it requires treatments for
several years and few may also require life-long treatment. The lifestyle and clinical related
factors like obesity, physical inactivity, high cholesterol, hypertension, depression, diabetes,
smoking, consumption of unhealthy diet rich with fat, salt and sugar as well as excess alcohol
intake have been recognized as the most common risk factors for several NCDs (National
Health Mission, 2018; Peters et al., 2019).
The increase in the non-communicable diseases day by day leads to morbidity and
mortality worldwide (WHO 2018; Budreviciute et al., 2020). The four major life-threatening
non-communicable diseases responsible for highest number of deaths among the globe are
cardiovascular diseases (17.9 million annual deaths; 31% of global deaths); cancer (9 million;
16%); chronic respiratory diseases (3.9 million; 7%) and diabetes (1.6 million; 3%). More
than 80% of premature deaths is mainly due these four groups of diseases. The mortality of
more than 15 million adult individuals aged 30–69 years were reported due to NCDs and
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85% of these are premature deaths mainly observed in low- as well as middle-income
countries. The burden of NCDs can be reduced through multi-sectoral effective prevention
measures (Mahat and Thapa, 2019; Akseer et al., 2020). World Health Organization along
with United Nations system agencies made several policies to reduce the risk, prevention and
control of NCDs (WHO, 2019; Budreviciute et al., 2020).
Kidney diseases are one of the important public health problems as approximately 850
million individuals are suffering from different types of kidney diseases around the globe (Li
et al., 2020; Lameire et al., 2021). Kidney diseases are of various types; while, those leading
to end-stage
renal disease (ESRD)
mainly
includes
inherited
kidney
diseases,
glomerulonephritis, infections, stones, obstructive uropathy, benign prostatic hypertrophy,
acute renal failure, chronic kidney disease (CKD) and kidney diseases due to diabetes and
hypertension (Driks et al., 2006). The prevalence of ESRD is more common among males
than females (Benjamin and Lappin, 2021).
Acute Kidney Injury (AKI), earlier known as Acute Renal Failure (ARF) is an
instantaneous decrease in the function of the kidney leading to both structural (injury) and
functional (impairment) damage (Srilakshmi, 2014; Makris and Spanou, 2016). This leads to
acid-base and fluid-electrolyte imbalance resulting in retention of nitrogenous waste products
in the blood (ANNA, 2019). Decreased glomerular filtration rate and increased proteinuria
are commonly observed in case of AKI (Hsu and Hsu, 2016). Individuals with or without the
history of kidney diseases may suffer permanent decrease in kidney functioning after the
single or repeated episodes of AKI (Henry Ford Health System, 2015). Acute kidney injury
has been classified into three stages based on the serum creatinine level and urine output as
stage 1 (Risk), stage 2 (Injury) and stage 3 (Failure). Loss of blood (due to accidents,
hemorrhages, during delivery), loss of plasma (due to burns), loss of fluids (due to vomiting,
diarrhoea, excessive sweating and urination), infections, surgical procedures and many more
serious health issues results in acute renal injury (Srilakshmi, 2014). Low urine volume,
nausea, vomiting, loss of energy, hypertension and anorexia are the common symptoms
observed in case of acute kidney injury. Elevated blood urea may also lead to mortality of the
suffering individual.
Chronic Kidney Disease (CKD) is one of the major public health issues worldwide,
contributing to increased rate of morbidity and mortality especially in low-income countries
(Ameh et al., 2020; GBD Chronic Kidney Disease Collaboration, 2020). CKD is due to both
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structural and functional renal abnormalities caused due to low nephron number from birth,
exposure to toxic components and certain diseases leading to severe kidney injuries and also
nephron loss due to aging (Srilakshmi, 2014; Romagnani et al., 2017). CKD is also known as
uremia and is the outcome of acute glomerulonephritis, pyelonephritis and nephrotic
syndrome. Various sociodemographic risk factors also play a major role in the development
of CKD like food insecurity, non-white race, low education and income (Chen et al., 2019).
Chronic kidney disease has been classified into five stages based on the estimated Glomerular
Filtration Rate (GFR) as stage 1, 2, 3A, 3B, 4, 5, 5D and 5T; where stage 5, 5D and 5T is the
end-stage renal disease requiring dialysis and kidney transplantation (Henry Ford Health
System, 2015). Dehydration, loss of appetite, vomiting, elevated blood pressure, oedema,
irregular heartbeat, anaemia, skin related problems and neurological issues are the certain
symptoms reported in individuals suffering with CKD (Srilakshmi, 2014; Webster et al.,
2017).
The mortality and morbidity due to kidney diseases is increasing in recent years in
India due to lack of knowledge, late diagnosis, less availability and higher cost for treatments
(Singh et al., 2013; Balasubramaniyan et al., 2020). As a developing country, India has
several challenges and situations that effect the early diagnosis and management of CKD as
the facilities and expertise available for the diagnosis of treatment are distributed unequally
around the country (Varughese and Abraham, 2018). Along with medication and therapies,
proper nutritional management/balanced diet is also necessary to the patients for effective
treatment and to avoid metabolic complications (Maurya et al., 2018). In current era, plantbased diets, Mediterranean diets and DASH (Dietary Approach to Stop Hypertension) plays a
major role in delaying the progression of CKD (Naber and Purohot, 2021). Kidney disease is
one of chronic non-communicable diseases leading to mortality and morbidity throughout the
globe. The lifestyle related factors like cigarette smoking, alcohol consumption and obesity
results in the development of chronic kidney disease. Along with various conventional
therapies, balanced nutrition helps in the healthy recovery of the patients. There are various
medical centers are distributed throughout the country uses many diagnostic methods to treat
different types of kidney diseases. Thus, the main aim of this study is to assess the prevalence
of different types of kidney diseases among men and women, role of dietary intake and
lifestyle impact on individuals with kidney diseases and also role of hospital diet in the early
recovery of the patients through survey and observational study in Father Muller Medical
College Hospital, Kankanady, Mangaluru.
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1.1
Introduction
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Objectives
The survey and observational study has been carried out in Father Muller Medical College
Hospital, Kankanady, Mangaluru with following major objectives.

Assessment of role of dietary intake among patients with kidney diseases

Assessment of lifestyle-related and other common risk factors for kidney diseases

Assessment of prevalence of renal diseases among men and women

Observational study on hospital diet given for kidney patients