More than 62 pc of Chronic Kidney Disease in India due to diabetes, hypertension and obesity: Expert

The prevalence of CKD and diabetic retinopathy (DR) increases proportionally to the disease duration in Type 2 Diabetes said Dr Naresh Purohit, Visiting Professor at the Thrissur based Kerala University of Health Sciences , School of Public Health.

Talking to UNI here after addressing the webinar on "Battle Against Renal Issues" organised by the Kollam based Government Medial College on the occasion of world kidney day, noted Epidemiologist he stated that less than 10% of the patients who develop kidney failure can afford to get treatment in the country, prevention is the best possible answer.

An estimated 3.5 -4 lakh new kidney failure cases are detected every year, of which less than half can avail of dialysis, a situation that is grimmer in rural areas with limited centres.

"When it comes to transplantation, the numbers were further skewed as only around 2-3% could afford the cost or find a donor," he added.

Principal Investigator of the Association of studies for Kidney Care Dr Purohit pointed that there is no doubt that the high prevalence – 20 % of the Kerala population being diabetic and 30 % hypertensive – and poor control rates are fuelling this burden of CKD and the catastrophic health expenditure on individuals and health system.

"It invariably says that our non-communicable diseases (NCD) care at the primary care-level is inadequate," he observed.

He averred that CKD has become a common but under-diagnosed problem.Research studies have shown that 1 out of 10 adult people worldwide have this disease.

"In the early stages, it is a silent disease and hence diagnosis is often delayed. If left untreated it can be deadly not only rapidly progressing to end-stage renal disease but also causing damage to other organs notably the heart," he cautioned.

He averred that as per the Global Burden of Disease (GBD) study of 2017, approximately 843.6 million individuals worldwide were reported to have CKD.

In 2016, an estimated 1.2 million persons died due to CKD, and it is forecasted that approximately 2.2–4.0 million lives will be lost to CKD by 2040.

"CKD and DR share common risk factors such as smoking, poor glycemic control, systolic hypertension, or dyslipidemia, development of DR may predict development and progression of CKD,"he added

Renowned physician emphasised that early detection allows for better disease care and management to helps prevent morbidity and mortality, and also improves cost effectiveness and sustainability.

"Inspite of recent advances in diagnosis and management, kidney disease related mortality continues to increase yearly and is projected to be the 5th leading cause of death by 2040," he said

Experts said that nearly 2 lakh patients die every year in the country due to a lack of awareness of kidney disease.

They said that it is the responsibility of governments as well as physicians to provide awareness, support, and reassurance to those people who are suffering from kidney disease to bring hope to life.

"The change in burden of CKD from 1990 to 2016 in terms of incidence, prevalence, death, and disability adjusted life years (DALYs) showed an alarming rising trend with CKD incidence increasing by 89%, prevalence by 87%, death due to CKD by 98%, and DALYs by 62%. This trend is driven partly by population growth, increased life expectancy and an aging population," experts revealed

"CKD presents an elevated risk of developing cardiovascular disease (CVD) and is also an independent risk factor for cardiovascular events." they said.

Experts informed that the poorly informed public and patients find it challenging to access scientifically authentic and validated information regarding treatment.

This is especially true for developing countries like India where there is a proliferation of quacks and untested therapies and regulatory mechanism are lax.

Experts shown concern that a significant number of affected people often land up in the hands of these quacks loosing precious time as well as money.

The widening knowledge gap is stifling the fight against kidney disease, and increasing the inherent associated mortality.

They emphasised to the general public to adopt healthy diet and lifestyles (access to clean water, regular exercise, healthy diet, avoid smoking) to maintain good kidney health, preserve kidney function longer in those with CKD, and increase overall general awareness of the importance of kidneys.

They underlined to educate and encourage primary care physicians to improve their recognition and management of patients with CKD across its entire spectrum from prevention and early detection of CKD to its secondary and tertiary prevention and kidney failure care.

Experts suggested to integrate CKD and kidney failure prevention into national non-communicable disease programs for comprehensive and integrated services, which are essential in improving the early detection and tracking of kidney care at country level.

(With UNI inputs)