CKD is an enormous public health issue, the tide of which continues to inexorably rise. Chronic kidney diseases (CKD) cause at least 2.4 million deaths per year and are now the 6th fastest growing cause of death.
AKI (Acute Kidney Injury) and CKD affect a large number of people worldwide and most of these cases are found in low and middle income countries.
Most importantly CKD & AKI increase the risk of morbidity and mortality from other diseases for including heart attack, diabetes mellitus, blood pressure and obesity, as well as infections such as HIV, malaria, tuberculosis and hepatitis.
Chronic Kidney Disease in India:
Hypovitaminosis A and other nutritional issues during pregnancy may cause smaller kidney volume at birth and a lower eGFR. Consanguinity and genetic inbreeding increase risk of congenital anomalies of the kidney and urinary tract and obstructive or reflux nephropathy. Poverty, poor sanitation, pollutants, water contamination, overcrowding, and known and unknown nephrotoxins (including heavy metals and plant toxins in indigenous remedies) may lead to glomerular and interstitial kidney diseases.
The reported prevalence of CKD in different regions of India ranges from <1% to 13%, and recently another data reported a prevalence of 17%. The etiology of CKD varies considerably throughout India. Parts of the states of Andhra Pradesh, Odisha, and Goa have high levels of CKD of unknown etiology (CKDu), which is a chronic interstitial nephropathy with insidious onset and slow progression.
The true burden of ESRD in India is not known, with few dedicated centers for care, lack of universal access to renal replacement therapy (RRT) and absence of a registry. HD is the most common modality of RRT followed by transplantation, and PD is a distant third.
High and increasing burden of kidney diseases in India and worldwide necessitates, need for strategies for kidney diseases prevention and management.
Kidney Health for Everyone Everywhere calls for universal health coverage (UHC) for prevention and early treatment of kidney disease.
HOW TO IMPROVE KIDNEY CARE?
- ADAPTING HEALTHY LIFE STYLES – access to clean water, exercise, healthy diet and tobacco control.
- SCREENING OF KIDNEY DISEASES – example urine and blood tests. Screening of especially high risk individuals (example diabetic patients) and early diagnosis and treatment will be cost effective, prevents or delays dialysis stage (end stage).
- ENSURING AVAILABILITY OF BASIC HEALTH SERVICES FOR KIDNEY DISEASE PATIENTS – example blood pressure & cholesterol and other essential medications to delay the disease progression.
- NEED OF TRANSPARENT POLICIES & ACCESS TO ADVANCED HEALTH CARE SERVICES – example Dialysis & kidney transplantation and better financial protection (subsidies) as more resources become available.
About the Author:
Dr. Ravi Sarvi, is a Nephrologist & Renal Transplant consultant, KLEs Dr. Prabhakar Kore Hospital, Belagavi