Psychosocial and economic impact of chronic kidney disease and haemodialysis on patients and households in resource poor settings: A Study from South India

Chronic kidney disease (CKD) has emerged as a major public health challenge worldwide. It is estimated that about 500 million people suffer from CKD, with 80% of them living in LMICs, and in India, population-based surveys have reported a high prevalence of CKD. The most commonly opted for, long-term treatment for CKD is haemodialysis. Facilities that offer haemodialysis in the public sector are currently limited to tertiary care hospitals situated in district headquarters or cities. Due to this, patients have to depend heavily on the private sector, for haemodialysis and other support services, which often results in huge out of pocket payments for the family. Apart from the direct treatment costs, patients also incur indirect costs when they are on long-term dialysis. CKD is also associated with various psychosocial issues such as depression, anxiety disorders, and cognitive impairments. Limitations posed by the illness, uncertainties in treatment, and the lack of social support often results in poor psychosocial functioning. There is a dearth of research focusing on the impact of such a chronic disease on patients and their families, as well as the challenges it raises for health systems, policies and programmes. With the current study, we aim to explore the psychosocial and economic impact of chronic kidney disease and its management on patients and their families. We would also try to understand how health service delivery systems cater to the needs of such patients and how different health policy initiatives address the high burden of chronic kidney disease.