Visakhapatnam: The Uddanam region in Srikakulam district continues to battle a high prevalence of chronic kidney disease of unknown aetiology (CKDu). A recent study underscores the multifactorial nature of the condition, linking it to a complex web of social, lifestyle, and health-related determinants.Individuals from lower hierarchical castes are disproportionately affected, and limited educational attainment significantly increases vulnerability. In Uddanam, where nearly one-third of the population is illiterate, lack of education stands out as a major risk factor—particularly among farmers and daily wage labourers engaged in paddy and cashew cultivation.Physical activity was found to be protective, with higher levels associated with reduced proteinuria—an early marker of kidney damage—and improved CKDu outcomes. In contrast, lifestyle behaviours such as tobacco use and consumption of locally brewed alcohol were strongly correlated with increased disease risk.Hypertension emerged as a critical contributor, with nearly half the population affected. This condition accelerates disease progression and increases the likelihood of end-stage renal failure, requiring dialysis or transplantation. The study also identified a range of comorbidities linked to CKDu, including gastrointestinal disorders, thyroid dysfunction, eye diseases, and anaemia.The research team included Hari Ram Pampana, Sadguri Addanki, Dhanunjaya Varma Lakkamraju, Prof Sudhakar Godi, and Prof Paddaiah Gangisetti from Andhra University’s Department of Genetics, along with John Dogulas Palleti from the Centre for Computational and Biological Science. Their findings were published in the African Journal of Biological Sciences.The retrospective case-control study involved 2,806 participants from two CKD hotspots—Kaviti and Kanchili. It included 1,001 CKD cases and 1,001 matched controls from Kaviti, and 404 cases with 404 controls from Kanchili. A significant difference in water intake was observed between affected and healthy individuals, reinforcing earlier research that links low fluid consumption to kidney disease.“Our study highlights the significant impact of socioeconomic disparities, lifestyle behaviours, hypertension, and comorbid conditions on CKDu prevalence in Uddanam,” the researchers stated. “Physical activity emerged as a protective factor, while limited education and lower caste status were major contributors. These findings underscore the need for targeted interventions to reduce disease burden and improve outcomes.“The study also revealed stark differences in healthcare costs between CKDu patients and healthy individuals. Expenses for transport, diagnosis, and medication rise sharply with disease severity. Patients in stages IV and V incur significantly higher treatment costs than those in earlier stages or healthy controls.