‘Silent pandemic’: Experts for early detection as kidney diseases rise

New Delhi: Kidney diseases rarely announce themselves. There is no sharp pain at the start, no obvious warning. For many Indians, the first real shock comes when a doctor says dialysis is now unavoidable. Ahead of World Kidney Day on March 12, doctors, policymakers and patient groups gathered at a conclave organised by Kidney Warrior Foundation in Delhi to mark 50 years of nephrology in India. The focus was not celebration, but concern — that India is detecting kidney ailments far too late.
Progressive kidney disease affects about 5%–6% of people. Instead of testing everyone, experts said the country must focus on early detection among high-risk groups — people with diabetes, hypertension, obesity or a family history of kidney diseases. Every clinic visit should be used as an opportunity to test vulnerable patients. Two simple checks — a blood test for serum creatinine and a urine test for albumin — can catch damage early.Senior nephrologists at the conclave, including D S Rana of Sir Ganga Ram Hospital, Urmila Anandh of Amrita Hospital, Shyam B Bansal of Medanta Institute of Nephrology and D Bhowmik of All India Institute of Medical Sciences, emphasised that these tests are affordable and widely available, yet many diabetic and hypertensive patients are never properly screened.The urgency is growing as the drivers of kidney diseases rise sharply. Chief guest Anupriya Patel described chronic kidney disease as a "silent pandemic", closely linked to diabetes, high blood pressure, unhealthy diet and sedentary lifestyles. Air pollution and extreme heat, she added, are emerging risk factors, and younger people are increasingly being affected.Regarding treatment, she cited the expansion of free dialysis under Pradhan Mantri National Dialysis Programme across 751 districts, with over 1,700 centres and more than 12,800 machines. Since 2016, over 31 lakh patients have received more than 4 crore dialysis sessions. Financial support for transplants and post-transplant medicines is also available under public schemes.Yet nephrologists stressed that dialysis is the final stage of disease, not the solution. By the time a patient requires dialysis thrice a week, kidney damage is often severe and irreversible — underscoring the need for earlier detection.Another concern that emerged was poor communication between doctors and patients. A study presented earlier this year at the conference of Indian Society of Nephrology surveyed 708 kidney patients across the country. Led by Vasundhara Raghavan, founder of Kidney Warrior Foundation, the research found that only 28% of patients said the purpose of their medicines was explained, and just 14% were told about side effects. Many admitted they did not understand why they were taking certain tablets. Those who felt hesitant to question their doctors were twice as likely to skip medicines.The foundation's journey reflects the human cost behind these numbers. It began after Raghavan donated her kidney to her teenage son when he developed end-stage disease. What started as an online support group in 2017 has since grown into a national patient movement running screening camps, mentoring families and advocating stronger prevention policies.For affected families, the financial strain remains crushing. Dialysis can wipe out savings. Even when treatment is subsidised, travel costs, medicines and lost wages add to the burden. Doctors promoted home-based dialysis as one way to ease pressure on both hospitals and households. The message from the conclave was clear: kidney diseases may be silent, but the impact is loud — in hospital wards and in homes pushed into debt. Detecting them earlier, testing smarter and clearly communicating the details of treatment to patients could prevent thousands from ever reaching that final stage.