In western countries, diabetes and hypertension account for over $2 / 3^{\text {rd }}$ of the cases of CKD. In India too, diabetes and hypertension today account for 40-60\% cases of CKD. As per recent Indian Council of Medical Research data, prevalence of diabetes in Indian adult population has risen to $7.1 \%$, (varying from $5.8 \%$ in Jharkhand to $13.5 \%$ in Chandigarh) and in urban population (over the age of 40 years) the prevalence is as high as $28 \%$. Likewise, the reported prevalence of hypertension in the adult population today is $17 \%$ (14.8\% from rural and $21.4 \%$ from urban belt). A similar prevalence of $17.4 \%$ has been reported by Panesar et al. (in the age group of 20-59 years) even from slum-resettlement colony of Delhi. With rising prevalence of these diseases in India, prevalence of CKD is expected to rise and obviously, this is the key target population to address.
A study published in this issue is from a rural belt of Karnataka. The population had a mean age of $39.88$ ± $15.87$ years with $3.82 \%$ prevalence of diabetes and $33.62 \%$ of hypertension. Authors found $6.3 \%$ prevalence of CKD stage 3; which is the highest reported till date by any Indian worker. It is disturbing to note, the high prevalence of hypertension in a rural setting where over $75 \%$ population had normal or low body mass index.
In comparison to most other published studies from India, the present study population is younger and even the prevalence of diabetes is low but surprisingly despite that prevalence of stage 3 CKD is reported to be higher $(6.3 \%)$. It is disturbing to see the rising prevalence of hypertension and CKD in rural belts. Possibly, with shifting population the difference between urban and rural areas is getting blurred. Undoubtedly, we need more Indian data to validate these findings.
(i) What is CKD ?
(ii) What are the major causes of CKD ?
(iii) In which segment of society is CKD more prevalent?
or
(iv) What is the highest percentage of CKD reported?
(ii) Diabetes and hypertension
(iii) Rural
or
(iv) $6.3 \%$







