Appendix I
DEFINITIONS
Chronic Kidney Disease (CKD)
1. Kidney damage ≥ 3 months with eGFR (estimated by any method) < 60 ml/min and /
OR
2. Structural or functional abnormalities as indicated by abnormalities in
 Pathology
 Imaging
 Urinalysis
 Blood composition indicating abnormal kidney function
Diabetic Nephropathy (DN)
1. Histological lesions of DN OR
2. Established Diabetes Mellitus for preferably > 5 years with fixed proteinuria of > 0.5
gm or with hypertension and abnormal eGFR OR
3. Established Diabetes Mellitus for preferably > 5 years / with fixed proteinuria of > 0.5
gm OR
4. Abnormal plasma glucose with proven diabetic retinopathy / with hypertension and
abnormal eGFR OR
5. Established diabetes mellitus with albumin create ratio of > 20 mg/gm with normal or
abnormal eGFR
Hypertensive Nephrosclerosis
1. Histological evidence of hypertensive nephrosclerosis OR
2. Sys. Hypertension of > 10 years of non renal parenchymal or renovascular etiology
with LVH / Hypertensive retinopathy OR
3. Accelerated / malignant HT with Neuroretinopathy / LV dysfunction with proteinuria
and altered eGFR
Renovascular Disease
1. Radiologically (angiographic / doppler) demonstrable significant bilateral renal artery
stenosis or significant disease in artery supplying solitary functioning kidney with no
other identifiable cause of CKD OR
2. Recently detected severe hypertension and peripheral occlusive vascular disease
(POVD), risk factors for POVD, h/o flash pulmonary edema, h/o >20% deterioration in
eGFR with ACEI / ARB use, renal and other vascular bruit, asymmetry in renal size
Chronic Glomerulonephritis (CGN)
1. Biopsy proven glomerular disease (must show evidence of dominant glomerular
involvement) OR
2. Significant proteinuria > 3 months duration with edema and/or hypertension and/or
gross or microscopic hematuria OR
3. History of nephritic or nephrotic illness in past OR
4. Biopsy proved glomerular disease
1
Note: Do not include Idiopathic nephrotic syndrome or minimal change disease that shows
primary steroid response within three months
Chronic Tubulo-interstitial Disease (TID)
1. Biopsy evidence of predominant involvement of tubulo-interstitial compartment OR
2. Presence of at least 2 of the following:
a) Absence of edema / hypertension until the stage of dialysis dependency
b) Evidence of marked rickets or osteomalacia
c) Radiological evidence of abnormalities of urinary tract
d) Proteinuria <1 gm/day
e) History of recurrent urinary tract infections
f) Identification of factor known to cause (e.g. drugs, toxins)
g) Urinary stone disease
h) Demonstrated vesico-ureteric reflux
i) Disproportionate metabolic acidosis
j) Longstanding polyuria and nocturia
Congenital Disease
1. Presence of renal disease at birth or infancy, nephrotic state, stones, obstructive
symptoms etc.
2. Specify type of renal disease
Heredofamilial
Heredofamilial diseases with family history suggestive genetic inheritance.
Cystic Disease
1. Autosomal dominant polycystic kidney disease (ADPKD) OR
2. Autosomal recessive polycystic kidney disease ( ARPKD)
Obstructive Uropathy
1. Objective evidence of anatomic or neurogenic obstruction to urinary tract at any level
preferably bilateral or unilateral in single functioning kidney AND
2. Exclusion of other causes of CKD
Graft dysfunction
Renal allograft recipient having evidence of CKD as defined above.
This should be entered under status Post-transplant.
Others
Any specific disease not covered in the above mentioned categories
Undetermined
CKD not fitting in any of the above categories
Please note
Histological diagnosis takes precedence over clinical findings
Please select only one cause
2
Supplementary Table 1: Patient characteristics in different years
Year
2006
2007
2008
2009
2010
Age
50.0±14.7
50.5±14.5
49.6±14.7
50.6±14.5
49.9±14.7
Gender
Stage of CKD
ratio
I
II
III
IV
V
Total
2.1:1
367
660
2,346
2,950
5,539
11862
(3.1 )
(5.6 )
(19.8 )
(24.9 )
(46.7 )
176
407
1,987
2,793
4,947
(1.7 )
(3.9 )
(19.3 )
(27.1 )
(48.0 )
278
556
2,167
2,734
5,295
(2.5 )
(5.0 )
(19.6 )
(24.8 )
(48.0 )
108
288
1,765
2,614
4,915
(1.1 )
(3.0 )
(18.2 )
(27.0 )
(50.7 )
76
226
1,349
1,594
2,867
(1.2 )
(3.7 )
(22.1 )
(26.1 )
(46.9 )
2.4:1
2.4:1
2.7:1
2.4:1
Figures in parentheses are percentages
3
10310
11030
9690
6112
Supplementary Table 2: Demographics and etiologic diagnosis in different stages of CKD
Age Gender
(years)
CKD Stages
Causes of CKD
ratio
Graft
(M:F)
I 37.411.7
2.3:1
II 43.612.8
2.4:1
III 51.013.6
2.8:1
IV 53.214.3
2.4:1
V 49.414.8
2.3:1
DN
UD
HT
CGN
CIN
Obs
ADPKD Others
failure
RVD
Total
263
154
142
151
60
54
26
134
7
14
1,005
(26.2)
(15.3)
(14.1)
(15.0)
(6.0)
(5.4)
(2.6)
(13.3)
(0.7)
(1.4)
647
320
273
325
153
76
49
268
10
16
(30.3)
(15.0)
(12.8)
(15.2)
(7.2)
(3.6)
(2.3)
(12.5)
(0.5)
(0.7)
3,102
1,515
1,299
1,321
676
315
245
1,119
28
84
(32.3)
(15.8)
(13.5)
(13.7)
(7.0)
(3.3)
(2.5)
(11.6)
(0.3)
(0.9)
4,177
2,003
1676
1625
877
445
351
1371
41
119
(32.9)
(15.8)
(13.2)
(12.8)
(6.9)
(3.5)
(2.8)
(10.8)
(0.3)
(0.9)
7,257
3,932
2,912
3,311
1,700
771
605
2,788
73
164
(30.8)
(16.7)
(12.4)
(14.1)
(7.2)
(3.3)
(2.6)
(11.8)
(0.3)
(0.7)
2,137
9,614
12,685
23,563
CKD: chronic kidney disease, DN: diabetic nephropathy, UD: undetermined, HT: hypertensive nephrosclerosis, CGN: chronic
glomerulonephritis, CIN: chronic interstitial nephritis, RVD: renovascular disease, ADPKD : autosomal dominant polycystic kidney disease
Figures in parentheses are percentages
4
Supplementary Table 3: Comparison of Age, gender distribution and CKD stages at the time of presentation in different
income categories
CKD Stages
Gender
Monthly family
ratio
income (Rs) Age (years)
(M:F)
I
II
III
IV
V
Total
<5,000
2.4:1
421
844
3,799
5,202
9,837
20,103
(2.1)
(4.2)
(18.9)
(25.9)
(48.9)
428
896
4,162
5,315
10,127
(2)
(4.3)
(18.9)
(25.4)
(48.4)
98
258
1,260
1,713
2,775
(1.6)
(4.2)
(20.6)
(28.1)
(45.5)
5-20,000
>20,000
49.9±14.7
50.0±14.6
51.0±14.4
2.3:1
2.4:1
Figures in parentheses are percentages
5
20,928
6,104
Supplementary Table 4: Etiological diagnosis in different income categories
Monthly
family
income
(Rs)
<5,000
Total
DN
UD
HT
CGN
CIN
Obs
ADPKD
Others
failure
RVD
5,772
3,995
2,347
3,104
1,406
814
544
3,289
42
156
520,000
>20,000
(26.9)
7,497
(33.6)
2,447
(18.6)
3,443
(15.4)
665
(10.9)
3,031
(13.6)
1,070
(14.5)
3,150
(14.1)
732
(6.6)
1,633
(7.3)
509
(3.8)
762
(3.4)
133
(2.5)
627
(2.8)
142
(15.3)
1,880
(8.4)
683
(0.2)
84
(0.4)
36
(0.7)
194
(0.9)
63
Graft
21,469
22,301
6,480
(37.8)
(10.3)
(16.5)
(11.3)
(7.8)
(2.1)
(2.2)
(10.5)
(0.6)
(1)
CKD: chronic kidney disease, DN: diabetic nephropathy, UD: undetermined, HT: hypertensive nephrosclerosis, CGN: chronic
glomerulonephritis, CIN: chronic interstitial nephritis, RVD: renovascular disease, ADPKD : autosomal dominant polycystic kidney disease
Figures in parentheses are percentages
6
Supplementary fig 1: Showing the locations of contributing centers
7
8