The rising prevalence of chronic kidney disease (CKD) in India is a cause for concern, with diabetic nephropathy being identified as a major contributing factor.
This edit piece is trying to explore the causes, impact, preventive measures, and the role of the government and healthcare system in addressing the time bomb of kidney diseases in India.
In India, the prevalence of chronic kidney disease (CKD) is reaching alarming levels, with an estimated 800 cases per million people. The incidence of End-Stage Renal Disease (ESRD) is also on the rise, with figures ranging from 150 to 200 cases per million people. This silent epidemic is a ticking time bomb that requires urgent attention and action.
BUT WHAT EXACTLY IS CAUSING THIS SURGE IN KIDNEY DISEASE IN INDIA?:
Chronic Kidney Disease (CKD) has emerged as a significant public health concern in India,, with recent studies indicating a notable increase in its prevalence. A systematic review and meta-analysis published in the Nephrology Journal revealed that CKD affects approximately 13.24% of adults in India.
The prevalence has risen from 11.12% between 2011 and 2017 between 2018 and 2023 among individuals aged 15 years and above. Notably, CKD, is more prevalent in rural areas (15.34%) compared to urban regions (10.65%), and among men (14.80%) compared to women (13.51%). The highest prevalence was observed in Southern India, reaching 14.78%
CAUSES OF KIDNEY DISEASE IN INDIA:
The most common cause of CKD in India is diabetic nephropathy. With diabetes becoming increasingly prevalent in the country, especially among the younger population, the number of cases of kidney disease is also on the rise.
Diabetes is a major contributor to renal failure deaths, further highlighting the crucial link between these two health conditions. Diabetic nephropathy along with hypertension, glomerulonephritis, and other factors such as genetics, poor lifestyle choices, and inadequate access to healthcare services, are all playing a role in the growing burden of kidney disease in India.
Lack of awareness about the importance of early detection and treatment of kidney disease is also a significant factor contributing to the escalating numbers.
THE IMPACT OF KIDNEY DISEASE:
The impact of kidney disease goes beyond just physical health. It also takes a toll on the mental, emotional, and financial well-being of individuals and their families.
The cost of dialysis and other treatments can be exorbitant, pushing many families into poverty. The need for kidney transplants further exacerbates the situation, as the demand for organs far outweighs the supply.
The increasing incidence of CKD has led to a corresponding rise in the demand for dialysis services. India adds approximately 220,000 new patients with end-stage renal disease each year, yet the country’s dialysis sector can accommodate only about 175,000 patients.
SEVERAL FACTORS LIKE AFFORDABILITY, ACCESSIBILITY, AWARENESS, AND EARLY MAINLY CONTRIBUTE TO THE LIMITED ACCESS TO QUALITY DIALYSIS IN INDIA:
AFFORDABILITY: Dialysis can be prohibitively expensive for many patients. On average, each patient requires 10 to 12 sessions monthly, costing approximately Rs 1,600 per session.
This amounts to about Rs 16,000 to Rs 18,400 monthly, and roughly Rs 240,000 annually. Additionally expenses include laboratory tests, doctor consultations, and medications.
ACCESSIBILITY: Most dialysis centers are located in urban and semi-urban areas, necessitating long-distance travel for patients residing in remote regions. This not only increases transportation costs but also imposes a significant time burden on patients.
AWARENESS AND EARLY DETECTION: Early detection and treatment are crucial for successful CKD management. However, many Indians are diagnosed at advanced stages of the disease.
A lack of awareness and limited access to healthcare professionals, especially nephrologists in tier 2 and 2 cities, exacerbate this issue.
OVERWORKED MACHINES:
India’s dialysis sector is under immense strain due to the rising number of chronic kidney disease (CKD) patients. With addition of approximately 220,000 new end-stage renal disease (ESRD) patients, the existing dialysis centers are overburdened, as they are required to cater to a patient load much higher than their designed capacity.
According to industry experts, we have around 6,000 dialysis centers functioning in India, as against an estimated demand of 15,000. This inadequacy poses significant challenges, particularly for economically disadvantages populations.
As a result, dialysis machines are running beyond their optimal capacity leading to frequent breakdowns, longer wait times, and suboptimal treatment for patients.
MOST MACHINES BEING IMPORTED AND EXPENSIVE:
One of the major challenges in expanding dialysis services is the high cost of dialysis machines, most of which are imported. The reliance on foreign manufactures makes these machines expensive, with each unit costing between Rs 8 lakh to Rs 15 lakh, depending on the technology and features.
Additionally, maintenance and repair costs are steep, as spare parts and servicing expertise are limited in India. This is the reason why treatment becomes unaffordable for many.
SCARCITY OF DIALYSIS MACHINES:
Despite the growing number of CKD patients, India faces an acute shortage of dialysis machines and centers. While urban areas have relatively better access, rural patients often need to travel long distances to the nearest facility. This not only increases the financial burden on families but also limits patient’s ability to adhere to their treatment schedule.
The government has launched initiatives like the Pradhan Mantri National Dialysis Program under the National Health Mission, but the demand still far exceeds supply.
COMPROMISED HEALTH AND LIFESTYLE OF PATIENTS:
The scarcity and overuse of dialysis machines significantly impact patient’s health and lifestyle. Many patients receive fewer dialysis sessions than medically recommended, leading to inadequate waste removal from the blood, which in turn causes complications such as fluid overload, high blood pressure, and cardiovascular issues.
Additionally, the physical and financial burden of frequent hospital visits disrupts work, education and overall quality of life for patients and their families. The lack of early detection and treatment further exacerbates the issue, as many CKD cases are diagnosed at advanced stages w hen treatment options are limited and costly.
PREVENTIVE MEASURES:
Preventing kidney disease in India requires a multi-faceted approach that addresses the various factors at play. This includes raising awareness about the importance of regular health check-ups, especially for those at high risk such as diabetics and individuals with a family history of kidney disease.
Lifestyle modifications such as maintaining a healthy diet, staying physically active, and avoiding harmful habits like smoking and excessive alcohol consumption, can also help reduce the risk of developing kidney disease.
THE ROLE OF THE GOVERNMENT AND HEALTHCARE SYSTEM:
The government and healthcare system in India also have a crucial role to play in tackling the growing burden of kidney disease. There is a need for increased investment in healthcare infrastructure, facilities, and trained medical professionals to provide early detection, diagnosis, and treatment of kidney disease.
Public awareness campaigns and education programs can also help raise awareness about the risk factors and symptoms of kidney disease, encouraging people to seek timely medical help.
GOVERNMENT INITIATIVES:
To address these challenges, the Indian government has implemented initiatives such as the Pradhan Mantri National Dialysis Program under the National Health Mission, which has led to the establishment nearly 1600 centers running around 11,000 heamodialysis machines in various parts of the country. Additionally, schemes like Ayushman Bharat have improved access to medical infrastructure, including dialysis services in tier 2 and 3 towns.
The private sector also plays a pivot role, with organized dialysis providers and startups introducing innovative business models to enhance the renal care ecosystem.
Despite these efforts, significant gaps remain in the availability and quality of dialysis services in India. A concerted approach involving government initiatives, private sector participation, and increased public awareness is essential to improve early detection, accessibility, and affordability of CKD treatment across the country.
CONCLUSION:
The time bomb of kidney disease in India is a reality that cannot be ignored. With the numbers on the rise, urgent action is needed to prevent and control the spread of this silent epidemic.
By addressing the root causes, raising awareness, and improving access to healthcare services, we can work towards stemming the tide of kidney disease in India and ensuring a healthier future for all. The clock is tickling, but there is still time to defuse the situation before it’s too late. While both government and private investment is being stepped up, in a country of 1.4 billion facilities will always be inadequate unless we Prioritizes Preventive Measures!
