Aandhras mysterious kidney disease - Uddanam Disease

With inputs from Agasthya Kantu

 There’s been quite a discussion raging on the issue of kidney diseases prevalent in northern AP. This doesn’t come as much of a surprise considering that several international reports mention this area as a high risk belt. Each year hundreds lose their live due to this disease. The horrific conditions people are going through in this region was shown in a recent documentary.

When Power star Pawan kalyan planned his trip to the corner districts of Andhra Pradesh every one was curious to know why? TV channels and News papers reported that he will be interacting with the victims of chronic kidney diseases in Uddanam- A remote hamlet in Srikakulam Dist. Although it has been nearly two decades since the first cases of CKD were reported in this region, no one has any idea whatsoever as to how it is caused. It is a mystery that even science couldn’t solve. Here is everything that you need to know about this deadly disease.

UDDANAM – The Sanskrit meaning of this word is A heaven with gardens. Yes, its a place that is beautiful like kona seema with lots of coconut trees and beautiful gardens. But this place has now turned into a living hell on this earth with chronic kidney disease of unknown etiology. Globally this Kidney disease is a health problem posing great challenges due to its negative impact on health and the cost of sustaining treatment for long term periods.

So What is this Uddanam Disease?

This is a form of Chronic Kidney Disease (CKD). The cause is unknown till date. The symptoms of this disease include:

•High Blood Pressure

•Urea, which is to be eliminated out by urine gets deposited in the Kidney

•Potassium accumulation in blood

•Red blood cells count decreased leading to Anemia.

•Fluid balance ( total amount of intake and output of water in body is distributed)

Scenario in Andhra Pradesh:

‘Uddanam Nephropathy’ more commonly known as Kidney Nephropathy is an endemic disease in the rural village of Uddanam, Srikakulam Dist. This region is full of greenery with full of Coconut plantations. Sompeta, Kaviti, Vajrapukotturu, Mandasa & Icchapuram Mandals fall in this region. As of 2016, about 3,200 people have paid the price dues to this disease.

According to a survey by the Harvard Medical School, kidney failure is leading cause of death in our country. Several Research groups have studied this disease extensively but couldn’t establish a proper cause of this disease. Some stated it maybe because of the water they drink, some say it could be because of the geographical region, some others have also said there may be genetic factors at play. Yet, till date nobody in the world has been able to discover the actual cause. To be brutally honest, there have been reports that at least one family member in each house in the region had been diagnosed with this disease. There have been several reported deaths in the area too.

Believing water to be the cause, several research studies have been carried out in the region stating that the bore-well water shouldn’t be consumed as they have residues of Lead and arsenic metals which can be a cause for this disease. There was an attempt to promote Safe drinking water (produced using Reverse Osmosis techniques) for drinking and cooking purposes. However, these steps did little to curb the disease as a whole.

Occupational affected farmers in this region are : Cashewnut, rice and coconut farmers

Age: all ages but most in 30-40 years if age.

Effected sex: Males are more prone than Females in the region.

Clinical Features:

*Proteinuria: excessive proteins in urine.( A healthy person’s urine has less proteins and if increased can suggest a kidney illness)

Although international funding research is done, the actual cause of this disease is yet to be found.

Strategic steps to try and curb this disease:

• Mass Screening: Collecting urine samples of every single individual

•Creatinine: screening of all samples of urine and estimating the creatinine and also protein levels

•Screening of high risk groups: a screening survey should be done for patients with diabetes, cardiovascular problems, Any family history of kidney related problems.

•Spreading Awareness to the Effected people confirmed in screening

•Advising compulsory RO drinking water to be used and are to be providing adequate quantities by the government by setting up small sized plants in every village.

•For end Stage individuals, setting a Medical Insurance covering all the health expenses including the dialysis.

•Providing a pension scheme for those affected who cannot work for a living and are the earnings individuals in the family.

•For convenient ground level monitoring, a teaching hospital like in a medical college in the district must set up compulsory rotations for interns in tandem with the local Rural and Primary Health centers.

•International Organization like WHO,Doctor Without Borders and state government funded camps are to be established for air level monitoring as well as for research.

•This camp must be functioning by collaborating Govt Doctors, Nephrologist as well as NGOs volunteers

•Regular visits by specialist from major health centers like AIIMS, NIMS and other centers for any updates or changes in the strategy plans in health care.

•Using Technology like Telemedicine to regular updates and monitoring at a super specialty center by the Nephrologists can also be done, if Visiting can’t be done regularly. Just using the service of Existing telemedicine center is enough and no need of setting up a new one which is very expensive.