India on brink of renal epidemic

If you are close to 50, suffer from hypertension, diabetes or obesity, have a stressful life, smoke, or take painkillers regularly, it is time you went for a kidney check-up. Health experts warn that with growing cases of diabetes and cardiovascular diseases in India, the country is on the brink of a chronic kidney disease (CKD) epidemic.

CKD is getting out of control because the treatment — dialysis or transplantation — is unaffordable for 90% of patients in the country. And the patients comprise a startling number: according to government estimates, two lakh people reach terminal kidney failure each year and millions suffer from less severe kidney
diseases.

The number will only go up: Experts say the Indian population group has a high rate of diabetes and high blood pressure, and is highly prone to CKD. “Instances of CKD have been rising over two decades because of rising cases of diabetes and cardiovascular diseases,” said Dr Sanjeev Gulati, senior consultant nephrologist, Fortis Hospital, Delhi.

A study in Delhi and surrounding areas by Dr Suresh Chandra Dash and Dr Sanjay K Agarwal of the nephrology department of the All India Institute of Medical Sciences revealed that 8 in 10,000 people suffer from CKD. The study, based on a sample size of 4,712, said that if the data is applied to India’s billion-strong population, there are 7.85 million CKD patients.

The study, published in the journal Nephrology Dialysis Transplantation, found the prevalence of conditions leading to CKD as: diabetes, 41%; hypertension, 22%; chronic glomerulonephritis, 16%; chronic interstitial disease, 5.4%; ischaemic nephropathy, 5.4%; obstructive uropathy, 2.7%; miscellaneous, 2.7%; and unknown causes, 5.4%.

“People who routinely take painkillers for muscular and back pain are also at high risk for CKD. High amounts of painkillers damage kidneys. Hence, all who pop painkillers must get a kidney test done,” Dr Gulati said.

Kidney ailment symptoms include body swelling, excessive urination at night, leakage of protein in urine, unexplained anaemia, shortness of breath and hypertension. CKD patients are also at high risk of heart disease.

What is to worry about, experts say, is that many people with CKD are in the dark. According to a recent paper in the American Journal of Kidney Diseases, nearly 50% of people with an advanced form of kidney disease do not know about this.

“People should get a periodic check-up done, including high blood pressure, urine and blood tests,” Dr Gulati said.