Risk of Renal Failure in Family Members of Dialysis Patients: Implication of Surveillance and Awareness Activities

A prospective observational study was conducted to identify high-risk populations for chronic kidney disease, create awareness through public education, and reduce the disease burden. Active screening was performed on 714 participants, including 357 first-degree relatives of patients with chronic kidney disease as the test group and 357 spouses as the control group. The test group showed higher average values for systolic blood pressure (140.10 ± 19.38 millimeters of mercury) and diastolic blood pressure (86.23 ± 5.11 millimeters of mercury) compared to the control group (123.70 ± 7.13 millimeters of mercury and 75.13 ± 4.91 millimeters of mercury, respectively). Fasting blood sugar levels and serum creatinine levels were elevated in the test group (2.10 ± 6.66 milligrams per deciliter) compared to the control group (0.93 ± 0.35 milligrams per deciliter). Additionally, the average urine albumin level in the test group (26.05 ± 8.04 milligrams) and the albumin-to-creatinine ratio were significantly higher than in the control group (13.23 ± 2.80 milligrams).

The study findings indicated that individuals with a family history of kidney failure, especially first-degree relatives, are at an increased risk of developing kidney disease compared to those without such a history. This emphasizes the importance of familial predisposition as a significant risk factor. Despite this, awareness of kidney disease was observed to be low among participants, highlighting the urgent need for targeted education and early screening programs to prevent the progression of kidney disease in high-risk groups.

1. Jacob SR, Raveendran R, Kannan S. Causes, comorbidities and current status of chronic kidney disease: a community perspective from North Kerala. J Family Med Prim Care. 2019;8(9):2859-63.
2. Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India. 2009;57(2):563-7.
3. Thankappan KR, Sivasankaran S, Sarma PS, Mini G, Khader SA, Padmanabhan P, et al. Prevalence-correlates-awareness-treatment and control of hypertension in kumarakom, kerala: baseline results of a community-based intervention program. Indian Heart J. 2006;58(1):28-33.
4. Tan J, Zwi LJ, Collins JF, Marshall MR, Cundy T. Presentation, pathology and prognosis of renal disease in type 2 diabetes. BMJ Open Diabetes Res Care. 2017;5(1):e000412. 
5. Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India - results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol. 2013;14:114.
6. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-305. doi:10.1056/NEJMoa041031
7. Jurkovitz C, Franch H, Shoham D, Bellenger J, McClellan W. Family members of patients treated for ESRD have high rates of undetected kidney disease. Am J Kidney Dis. 2002;40(6):1173-8. 
8. Freedman BI, Volkova NV, Satko SG, Krisher J, Jurkovitz C, Soucie JM, et al. Population-based screening for family history of end-stage renal disease among incident dialysis patients. Am J Nephrol. 2005;25(6):529-35.
9. Takahashi S, Okada K, Yanai M. The kidney early evaluation program (KEEP) of Japan: results from the initial screening period. Kidney Int Suppl. 2010;(116):17-23. 
10. Ghaderian SB, Beladi-Mousavi SS. The role of diabetes mellitus and hypertension in chronic kidney disease. J Renal Inj Prev. 2014;3(4):109-10. 
11. Raji YR, Ajayi SO, Tayo B, Burke D, Gbadegesin R, Ojo A, et al. Genetic determinants of increased burdens of cardiovascular disease in patients with chronic kidney disease: a narrative review of the literature. Trop J Nephrol. 2022;17(22):278-94.
12. Maclasaac RJ, Jerums G, Ekinci EI. Cardiorenal protection with empagliflozin. Ann Transl Med. 2016;4(20):61-81.
13. Plantinga LC, Crews DC, Coresh J, Miller ER 3rd, Saran R, Yee J, et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol. 2010;5(4):673-82. 
14. Gouda Z, Mashaal G, Bello AK, El Attar A, El Kemmry T, El Reweny A, et al. Egypt information, prevention, and treatment of chronic kidney disease (EGIPT-CKD) programme: prevalence and risk factors for microalbuminuria among the relatives of patients with CKD in Egypt. Saudi J Kidney Dis Transpl. 2011;22(5):1055-63. 
15. Qari SA, Mansoury MM. Ameliorating effect of Paeonia officinalis on methotrexate-induced renal toxicity in rats: antioxidant and anti-inflammatory mechanisms. J Biochem Technol. 2023;14(4):1-8.
16. Sheshadri A, Kittiskulnam P, Johansen KL. Investigating the effects of physical activity on the amount of muscle cramp pain in hemodialysis patients. J Integr Nurs Palliat Care. 2024;5(1):8-13.
17. Ahmad S, Khan TM, Ayub F, Mubarak N, Mohammed A, Khalil AA, et al. Meta-analysis of urinary tract infections among patients with chronic kidney disease. Bull Pioneer Res Med Clin Sci. 2022;1(1):30-50.