A ticking time bomb: Over 7.8 million people suffer from CKD in India

Hyderabad: Global medical experts believe that Chronic Kidney Disease (CKD), which presently ranks 16th in terms of causes of death, will soon overtake all other causes as the leading cause of death.

Since CKD is caused by a poor diet and sedentary lifestyle patterns, there has been an increase in its global prevalence, which is now 13.4%.

The increasing prevalence of CKD is a result of several factors, including associated chronic conditions such as diabetes, hypertension, and high blood pressure that cause interstitial kidney disorders.

Additionally, the effects of numerous life-threatening triggers tend to cause a precipitous reduction in kidney function. Therefore, it is crucial to comprehend standardized conservative care to preserve renal health on a personal level. Most crucially, difficult patient care in terms of availability, pricing, and lax awareness is contributing to the expansion of the disease load that currently exists.

What is CKD?

A progressive loss of kidney function is a feature of chronic kidney disease, commonly known as chronic kidney failure. Wastes and extra fluid are removed from your blood by your kidneys and then passed through your urine. Your body may accumulate hazardous amounts of fluid, electrolytes, and wastes if you have advanced chronic kidney disease.

Dr. S. Gopulani, Consultant Nephrologist at NephroPlus, India's largest chain of dialysis facilities and the country's forerunner in preventative kidney care, draws attention to certain grave concerns about kidney disorders in India as a result of the country's neglecting renal health. Excerpts:

1. Is kidney health receiving adequate attention from policymakers?

More and more people are becoming aware of the burden of chronic kidney disease (CKD) and its effects on both individuals and society. A condition that was formerly believed to be a death sentence for the patients has now improved significantly. Undiagnosed and untreated kidney illnesses cause 1.7 million deaths worldwide each year, which warrants greater attention. According to the International Society of Nephrology, 7.8 million people in India alone have renal disease, and the prevalence is growing at a rate of 17%.

Several gaps and difficulties were found in the early diagnosis of CKD, its prevention, and potential treatments. The worst patient outcomes typically occur in nations that do not prioritize renal health and have extremely low health indices.

The emphasis must move to community-level early detection of chronic kidney disease, and access to specialists needs to be expedited. Due to problems accessing healthcare, over half of the patients with severe CKD appear right before requiring dialysis. Patients with chronic kidney disease sometimes don't exhibit symptoms, unlike some other illnesses. To diagnose CKD at an early stage, public health awareness is essential.

Numerous non-medical or social factors were shown to have an impact on patients' health. Education, living conditions, gender inequities, racial discrimination, and political and legal frameworks have all been demonstrated to significantly affect the results related to CKD. The majority of these variables are changeable, and it is here that government measures will help CKD patients.

To help close some of the gaps, the World Health Organization has developed initiatives (Package of Key Noncommunicable Disease Interventions). Community physicians can use simple-to-follow modules created by the Indian Society of Nephrology to assist in the management of patients with CKD. More emphasis is being placed on the value of screening people with diabetes, hypertension, and a family history of CKD. Some impoverished patients are receiving free access to transplant and hemodialysis services thanks to the government of India's health initiatives. Although just a small portion is served by these initiatives, it is nevertheless a positive development.

2. What are the leading causes of kidney diseases?

The two main factors contributing to kidney damage are diabetes and hypertension. These could be responsible for up to two-thirds of CKD cases. Patients with these disorders must have regular (at least yearly) screening tests done for things like blood pressure, blood sugar, urine protein, and creatinine. For risk reduction, any abnormalities in these screening tests could be examined by a nephrologist.

The remaining third of CKD may be brought on by less common conditions like glomerulonephritis (inflammation of the kidneys' filtering units), inherited illnesses like polycystic kidney disease (kidney cysts or water bubbles), urinary tract obstruction or malformation, kidney stones, and auto-immune diseases (in which the body attacks itself), like lupus or vasculitis. Kidney function may occasionally be compromised after a serious infection episode. The majority of patients' kidneys may heal, but in a small number of cases, permanent damage may result.

3. How to detect the early signs and symptoms of CKD?

The majority of patients with kidney illness may not have any symptoms. A bike or car's fuel tank might make an excellent comparison. Even when the gasoline supply is low or about to run out, the car idles quietly. The vehicle would abruptly halt without much of a change in performance unless we checked the meter and filled it. Likewise, CKD may not be detected early on without routine screening testing.

Patients with advanced CKD may experience symptoms such as swelling of the legs and face from fluid buildup, poor blood pressure management, dyspnea, weariness, and malaise. Those who need dialysis may exhibit excessive exhaustion, weight loss, nausea, vomiting, sleep difficulties, breathlessness, itching, dry skin, and loss of appetite.

4. How does a low-income patient seek affordable treatments?

The Indian government made stand-alone hemodialysis units accessible to patients who need free dialysis as part of the union budget for 2016. National services for dialysis District hospitals are now permitted to offer free dialysis to the poor as part of a program.

Kidney transplantation might be made easier with additional cash, such as the Chief Minister's and Prime Minister's relief funds. Low-income patients have access to state-run hospitals and government agencies that provide economical dialysis care.

5. What are your suggestions to build and amplify awareness for good kidney health?

The government should acknowledge that CKD poses a serious risk to India's efforts to improve its health status. In terms of increasing public and political understanding, we have made significant progress.

The message would be driven further with frequent national advertising, social media marketing online, TV, and radio.