Chronic Kidney Disease

Dr Shyam Bihari Bansal
Chronic Kidney Disease (CKD) is one of rapidly increasing causes of disease and death in India and worldwide at present. Approximately 10% of population is affected by various grades of CKD in India out of which 2-2.5 lakh people develop kidney failure.Kidney failure means that function of kidneys is reduced to less than 15% and patient would need either dialysis or kidney transplantation to survive. CKD is 17th leading cause of death across the world but in India, it is the 8th most common cause of death. In 2015 approximately 1.3 lakh peoples died of kidney failure in India. In India, out of 2-2.5 lakh people with kidney failure each year, only 50000-60000 receive the dialysis and 6000-7000 get the kidney transplant, which is the best treatment for this disease. The reason for this is lack of infrastructure, financial problems and unavailability of kidney donors for transplant.
The world kidney day
The world kidney day is an effort by national kidney foundation to increase awareness about kidney diseases in general public. It is celebrated on second Thursday of March every year throughout the world. The NKF have a theme for world kidney day every year and this year theme is women and world kidney day. As women are neglected many times as far as access to health care is concerned and half of the patients with kidney diseases are females and in our day to day practise we see that about 70% of all patients coming for treatment are male.
So what are reasons for this alarming rise in CKD and high death rates?
This is related to increase in diseases which cause CKD, i.e. -the most common cause of kidney diseases are diabetes and hypertension. India is diabetes capital of world and with increase in incidence of diabetes, there is proportionate increase in CKD and about 40% of all kidney failure is due to diabetes. Hypertension again affects 25% of population and poor control of blood pressure is one of the causes of rise in kidney disease. Other causes of CKD are- chronic glomerulonephritis in which there is higher protein excretion from urine which if not treated properly can gradually lead to kidney failure. Kidney stones if not treated on time would cause kidney failure especially those causing obstruction to urine flow and some familial diseases, most common is- polycystic kidney disease in which many cysts are formed in kidneys and it gradually leads to kidney failure. Other risk factors for CKD are: strong family history of kidney disease, smoking, obesity, old age etc.
How to prevent or detect CKD early
It is important to detect the onset of kidney diseases as early as possible as early detection can help in slowing the disease process and sometimes reversing it also.  For patients who have high risk of kidney disease like diabetes, hypertension, family history etc. should be evaluated yearly by urine examination for protein/albumin in urine and blood test for serum creatinine to know kidney function and if any of this is abnormal, than such a person should consult a kidney specialist (Nephrologist).
The way forward
Early detection and prevention is the key. Spreading awareness about kidney disease in general public is a very important way to reduce the burden of disease. The world kidney day is one such effort. Once kidney disease happens the person should consult a nephrologist to get optimum treatment of disease. The government should provide access to dialysis in remote areas and to overcome the problem of donors, public should be made aware about benefit of kidney donation, so more and more patients can get this benefit and live longer.
(The author is Director, Nephrology and Kidney Transplantation Medanta-Medicity, Gurgaon)