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As morning sunlight filtered through the windows of a Delhi hospital’s dialysis ward, patients shifted uncomfortably, adjusting the catheters in their arms. The rhythmic hum of machines underscored a stark reality—their lives had been upended. A year ago, many managed businesses, ran households and planned their futures. Now, they spend hours three days a week, tethered to dialysis machines, battling an illness they never anticipated: chronic kidney disease (CKD), a silent epidemic tightening its grip on millions of Indian families.
On World Kidney Day, experts sounded the alarm over the rapid rise of kidney disease in India, which affects nearly 17% of the population, according to a study in the Indian Journal of Nephrology. Yet, awareness remains dangerously low.
Late Diagnosis: A Hidden Danger
“Most people don’t realise their kidneys are failing until it’s too late. By the time symptoms appear including fatigue, swelling, or breathlessness, the majority of kidney function is already lost. At this stage, the damage is usually irreversible, making early detection through routine screening crucial,” said Dr. Umesh Gupta, Director, Nephrology, Aakash Healthcare.
What makes kidney disease particularly insidious is its deep connection to other common health conditions. Diabetes for instance, is a major culprit. Dr. Reetesh Sharma, Director & Head of Nephrology & Kidney Transplant Medicine at Asian Hospital said “Uncontrolled blood sugar damages the tiny blood vessels in the kidneys, impairing their ability to filter waste. This is why nearly 30% of diabetic patients eventually develop kidney disease.”
Chronic Kidney Disease (CKD) is primarily caused by diabetes and hypertension in India. Both conditions gradually damage the kidneys without causing noticeable symptoms in the early stages. As a result, the disease often remains undiagnosed until more than 80% of kidney function is lost.
For most of the patients, the warning signs are always there—uncontrolled hypertension, occasional swelling in their legs—but they never link them to kidney disease.
Heart-Kidney Connection
“The kidneys and heart share a crucial connection, functioning as two sides of the same coin. When the kidneys fail, excess fluid and toxins accumulate in the body, placing extra strain on the heart. This increased workload can result in high blood pressure, heart failure, and a significantly elevated risk of strokes and heart attacks,” said Dr. Soubeer Ghosh, Consultant, Nephrology and Kidney Transplant Medicine, PSRI Hospital, highlighting the link between CKD and hypertension.
Barriers to Early Detection and Treatment
While prevention is possible, access to treatment remains a challenge. According to a report by the Indian Society of Nephrology, India faces a massive shortage of dialysis centers, with only one center for every 3 lakh people. This leaves thousands struggling to afford life-saving care. “The biggest challenge in kidney disease is early detection. Routine tests like urine analysis and blood creatinine levels can identify kidney dysfunction long before symptoms develop, allowing for timely intervention. However, awareness about these screenings is still low, especially in rural areas, leading to late diagnoses when kidney damage is already advanced,” said Dr. Aakaar Kapoor, CEO and Lead Medical Advisor: City X-Ray and Scan Clinic Founder and Partner: City Imaging & Clinical Labs.
Cognitive Impact of CKD
For those already living with kidney disease, the complications go beyond physical suffering. Neurological issues, such as memory loss and difficulty concentrating, are common. “When the kidneys fail to filter toxins efficiently, these harmful substances build up in the bloodstream and eventually reach the brain. This can lead to cognitive impairment, causing symptoms like memory loss, difficulty concentrating, and mental fog. Many patients describe feeling confused or sluggish, which can significantly impact their daily lives,” said Dr Praveen Gupta, Principal Director and chief of Neurology, Fortis Hospital.
New diabetes medications offer kidney protection
“In diabetes management, maintaining a glycated hemoglobin (HbA1c) level below 7% is essential through dietary modifications, lifestyle changes, and medication. Newer diabetes medications not only control blood sugar levels but also provide kidney protection, slowing the progression of CKD and even benefiting non-diabetic patients by reducing urinary protein loss.
For hypertension management, a target blood pressure of less than 130/80 mmHg should be maintained through dietary changes, exercise, and medication. Certain antihypertensive medications offer kidney protection and should be prioritized in treatment plans. These drugs help manage associated cardiovascular diseases and delay the deterioration of kidney function,” said Dr. Mahendra Dadke, Consultant, General Medicine, Jupiter Hospital.