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Chronic kidney disease in India: challenges and solutions
1Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India. skagarwal58@yahoo.co.in
Nephron. Clinical Practice
|February 6, 2009
Summary
Chronic kidney disease (CKD) in India affects 800 per million population, with diabetic nephropathy as a leading cause. Early screening for CKD and its risk factors is crucial due to limited renal replacement therapy availability.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- Chronic kidney disease (CKD) poses a significant global health challenge, impacting morbidity and mortality even in developing nations.
- Accurate assessment of CKD burden in India is lacking, with an estimated prevalence of 800 per million population (pmp) and end-stage renal disease (ESRD) incidence of 150-200 pmp.
- Diabetic nephropathy is identified as the primary cause of CKD in population-based studies within India.
Purpose of the Study:
- To assess the current landscape of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in India.
- To evaluate the availability and accessibility of renal replacement therapy (RRT) options, including hemodialysis, peritoneal dialysis, and transplantation.
- To highlight the challenges and recommend strategies for managing the growing burden of CKD in India.
Main Methods:
- Review of existing epidemiological data on CKD and ESRD prevalence and incidence in India.
- Analysis of the current infrastructure for RRT, including nephrologists, dialysis units, dialysis stations, CAPD patients, and transplant centers.
- Examination of the costs associated with different RRT modalities and immunosuppressive therapies.
Main Results:
- India has a substantial burden of CKD, with limited RRT accessibility, serving only 10% of new ESRD cases annually.
- Hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), and kidney transplantation present significant cost barriers for patients.
- Government initiatives, including establishing affordable hemodialysis units and a National Organ Transplant Program, are underway but implementation is ongoing.
Conclusions:
- Despite recent government efforts, India faces considerable challenges in addressing the CKD epidemic.
- The limited reach of renal replacement therapy underscores the need for increased infrastructure and affordability.
- Screening high-risk individuals for CKD and its associated risk factors is the most pragmatic approach in the current scenario.
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