Chronic problem

The growing incidence of chronic kidney disorders (CKDs) in India is reason for concern. Around 1.5 lakh new cases of kidney failure are diagnosed annually in the country and according to the World Health Organisation, over 2.5 crore people in India could develop CKD in the next two decades. Health experts are warning that the incidence of CKD is poised to grow as diabetes and hypertension — two of the major causes of kidney disease — are rampant. With India emerging as the world’s diabetes capital, it is not surprising that CKD cases have grown dramatically in recent years. However, CKD is not inevitable for those with diabetes or hypertension. It can be prevented. Hence, careful monitoring of those who are at risk of being inflicted with CKD is an imperative. Early detection of CKD is also important as treatment is available.

CKD was once regarded as fatal. Not anymore, with dialysis treatment and kidney transplants providing those with CKD with hope and a new lease of life. However, high cost and lack of trained technicians and nurses is standing in the way of thousands of patients seeking dialysis treatment. The sophistication of dialysis treatment has improved remarkably as has the number of hospitals providing dialysis. But treatment remains elusive, thanks to the prohibitive costs of dialysis. In Bangalore, for instance, only 22.5 per cent of patients requiring dialysis are able to access the treatment. Most of those who begin treatment cannot afford to continue it. It is said that nationwide some 9,000 patients begin dialysis every year but around 60 per cent of them do not return for treatment. This high treatment drop-out rate means that most CKD cases in the country result in death.

Major strides have been made in kidney transplantation. The lifespan of people who have undergone transplants has increased. However, there are stumbling blocks here too. An important obstacle is the low availability of kidneys for transplant. This shortage has encouraged a booming and highly exploitative trade in kidneys. Public reluctance to donate kidneys of brain-dead kin remains formidable. While the government has taken many steps to improve availability of kidneys for transplantation, these have not worked sufficiently. Public awareness is low. People should be made to understand that donation of organs of a single person gives a new lease of life to nine others. CKD need not be fatal if treatment becomes more accessible and affordable.