Dr. Ratan Jha
In India, nearly one in six people suffer from kidney disease, with women bearing a heavier burden. Chronic kidney disease (CKD), defined as lasting longer than three months, affects around 10% of the adult population and is a leading contributor to premature deaths—mainly due to linked cardiovascular complications. Despite the availability of treatments such as dialysis and kidney transplantation, their high cost places them out of reach for a large segment of the population, deepening the crisis.
The kidneys play vital roles in maintaining bodily functions. They regulate water volume to ensure proper hydration and filter impurities from the blood, eliminating waste products such as urea, creatinine, uric acid, and electrolytes. Additionally, the kidneys produce hormones that regulate various bodily functions, including blood pressure, bone health through vitamin D activation, and red blood cell production in the bone marrow.
Kidney dysfunction can lead to various symptoms and complications, including reduced urine output, swelling due to fluid retention, electrolyte imbalances, elevated blood pressure, bone fragility, and anemia. As kidney function declines, waste accumulates in the blood, a condition known as uremia, potentially impacting other organs.
In advanced stages, when kidney function drops below 15%, termed kidney failure, patients may require dialysis or a kidney transplant for survival. However, both options pose challenges, with dialysis being costly and time-consuming, while organ shortage complicates transplant procedures.
Dialysis is a crucial treatment for kidney failure, efficiently removing waste products and unwanted substances from the body. Hemodialysis involves pumping blood out of the body into a machine for filtration, commonly performed through a fistula or neck catheter. Peritoneal dialysis, preferred for pediatric patients, uses the abdominal cavity as a filter. Both forms offer effective clearance of toxins from the blood, differing in technique and suitability for different age groups.
Kidney transplantation is the optimal treatment for eligible individuals with kidney failure. In this procedure, a new organ is transplanted into the recipient’s body, usually positioned in the lower abdomen alongside the existing damaged kidneys. While a kidney transplant offers the best long-term outcomes, the old kidney is typically left in place unless there are specific reasons for its removal, such as infection or space constraints.
Chronic kidney disease (CKD) is currently incurable, necessitating lifelong management. Nonetheless, early detection and appropriate treatment can enable patients to lead relatively normal lives. Therefore, raising awareness, promoting early detection, and prioritizing preventative measures are essential in addressing the challenges posed by kidney disease.
Key risk factors for kidney disease include high blood pressure, diabetes, family history of kidney diseases like polycystic kidney disease, obesity, age over 50 to 60 years, and certain ethnicities, such as South and Southeast Asians, who are at higher risk. Encouraging individuals with these risk factors to seek medical evaluation is crucial for early detection and management.
There are eight golden rules to promote kidney health, including staying physically active, maintaining a healthy diet, controlling blood glucose levels (especially for individuals with diabetes), regularly monitoring blood pressure (preferably using home blood pressure monitoring devices), maintaining a healthy weight, ensuring adequate fluid intake, avoiding harmful habits like smoking and excessive alcohol consumption, and using over-the-counter medications judiciously while seeking medical advice for long-term use.
Dr. Ratan Jha is Sr. Nephrologist & Transplant Physician, CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad