Surge in non-communicable diseases leads to kidney failure

With as many as 50 per cent of dialysis patients suffering from diabetes, other contributing factors are obesity, while high cholesterol and sedentary lifestyle aggravate the risks. it is more imperative to look at prevention, says Dr R Vijayakumar, Head of Nephrology Department, Billroth Hospital. 

He adds, “When it comes to diabetes management, people believe that keeping sugar levels alone under control is sufficient. They do not realise that the earliest indication of presence of protein in urine could go a long way in preventing patients from ending up with chronic kidney disease. Early detection of kidney disease and controlling required parameters is the best option. Tests like detection of Micro Albuminuria are expensive and people do not go in for it.” 

Dr Ram Prabahar, Joint Director, Institute of Renal Sciences, SIMS, says that ultrasound, urine test, blood urea serum creatinine tests must be made compulsory for all diabetics regularly. “Apart from these those above 40, those with family history of kidney disease and those with blood pressure must undergo these tests periodically,” he says. 

“Managing kidney diseases would be effective, if people diligently follow doctor’s instructions,” points out renowned nephrologist, Georgi Abraham. “There is very little taught about the kidney in MBBS curriculum. Therefore doctors may mismanage the condition,” he elaborated. 

Dr Georgi also says that the tropical weather makes Indians more vulnerable to the condition. “Studies show that there is a high prevalence of kidney disease in developing countries, it is related to the hot climate. Nation-wide screening is required and if progression is reversed,  there is no need for dialysis and transplant. Simple creatinine and urine tests can establish the presence of kidney problems. While we are creating awareness through our activities, it is reaching only a few people,” he says, adding that at the Ambattur Rotary Hospital they have a screening clinic every week. 

Dr Vijayakumar adds that while the city has a very robust dialysis set up, a lot more investment in infrastructure must continue. “We need quality dialysis and qualified staff at all centres,” he adds, saying that in India, as many as one lakh people must be on dialysis at one point in time. 

Dr Abraham says that apart from government, society with trusts, NGOs and private organisations too have the role to make dialysis available for all. There is a huge gap between the actual numbers who need dialysis and the ones who undergo the treatment. Meeting the needs is not just the government’s job, but each one of us, including specialists and NGOS, have a big role to play, he says. 

Experts take the example of the United States, where government funding dialysis costs, was proving to be unfeasible. Dr Prabahar adds, “However, there the rates are coming down and that is due to aggressive screening. It will take a while for India to reach that stage.”

It has been found that diabetes and hypertension account for over 2/3rd of the cases of CKD (Chronic Kidney Disease). Diabetes is prevalent all over the world.

In India, the burden of diabetes is very high with 69.2 million people living with diabetes as per the 2015 data. Of these, over 36 million people remained undiagnosed.

Chennai in particular, has the largest population of diabetics with an estimated 25 per cent of the adult population over 30 years