Management of Chronic Kidney Disease in India

When it comes to kidneys, Chronic Kidney Disease, or CKD, is the most common type of kidney disease. It refers to an ailment in which one’s kidneys get damaged and can’t filter out blood efficiently. It is regarded as a chronic disease because the damage happens slowly over time. India has experienced a surge in patients with CKD due to an increase in the number of people suffering from diabetes and hypertension. People unfortunate enough to contract this disease face a real challenge because kidney transplant costs are very high, and the wait for an organ donor is very long.

Common Types of Kidney Diseases

      Kidney stones

      Polycystic kidney disease

      Chronic kidney disease

      Glomerulonephritis

      Urinary tract infections

The Challenges of Chronic Kidney Disease in India

In India, it is difficult to assess the extent of CKD because there is no data collected on its pattern or magnitude. India does not possess a formal system to manage CKD patients. Treatment for kidney diseases is accessible mainly through higher-level healthcare facilities. As a result, due to a shortage in publicly funded hospitals specializing in kidney treatment, the patients are forced to turn to expensive private hospitals for care. Most patients do not even have health insurance, and it, therefore, becomes increasingly difficult to fund their treatment. Kidney transplant costs in India can range between Rs. 5 to 10 lakhs, and post-operative treatment costs for patients can go up to Rs. 15,000 per month, including medicines.

Many Indian patients cannot afford a kidney transplant. These people require dialysis treatment their whole life, and it is mainly private hospitals that run dialysis units. The truth is that many Indians cannot even afford the cost of dialysis. The lucky ones who can afford kidney transplant costs have other challenges such as organ trafficking.

Due to such challenges, which are mostly monetary, there should be a prevention program for CKD whose cost must be much less than that of the treatment.

Progress and Solutions in Managing Chronic Kidney Diseases

Until the last decade, the Indian public health system did not recognize CKD as a health issue. Studies were, however, started around 2005 on the various aspects of CKD. One of the studies initiated in 2010 by the Indian CKD Registry office shows the following demographics and socioeconomic status of CKD patients in India for that year: 

 

Number of cases

52,273

Age of patients

50 ± 15 years

Monthly family income

< Rs. 5,000

Between Rs. 5,001 and 20,000
> Rs. 20,000

 

42.7%
44.4%

12.9%

 

It is apparent from the table that most families cannot afford kidney treatment. As a result, measures have been taken by the government of India to try and remedy these challenges. Following are some of the actions undertaken and implemented by the government: 

   Increased funding and sponsoring dialysis and other related treatments for beneficiaries of the Central Government Health Services.

      Initiation of a process to have stand-alone hemodialysis units.

   Launch a National Organ Transplant Program (NOTP) to facilitate living and cadaver organ transplantations. A dedicated budget has been provided for this program to relieve the pressures on people who cannot afford kidney transplant costs.

Despite these initiatives, it is clear that priority must be put on CKD prevention programs by the Indian government due to the high costs of treatment. Unfortunately, CKD prevention is not yet a reality. A CKD prevention program has been put in place but with minimal budgetary support, and it is secondary to prevention programs such as those for diabetes, cardiovascular diseases, and strokes. The government has, however, launched encouraging initiatives to screen patients with a higher risk of CKD, including those suffering from diabetes and hypertension. However, as awareness about the significance of CKD as a national health issue is growing, more investments are being made in such programs. As a result, India will see better results and implement more cost-effective measures to fight CKD.  

Prioritize Prevention over Treatment

Chronic Kidney Disease is developing into a problem of large proportions in India. The issue will keep increasing further as more people suffer from diabetes and hypertension and as the elderly population continues to grow. The Indian government should be commended on the measures it has taken to improve the healthcare of CKD patients. However, the focus now should be on implementing better and more efficient prevention programs, as kidney transplant costs and treatments are not affordable to the general population. It is encouraging to see that the government has taken steps to raise awareness on CKD issues and more investments towards establishing such prevention programs. The future should hold better results. 



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