138 Million Indians Have Kidney Disease and Most Will Never See It Coming
By Arunima Rajan
In an interview with Arunima Rajan, Dr. Manish Singla, Senior Consultant, Urology, RG Hospitals, says that dialysis is a life-saving therapy but it is also resource intensive, particularly in terms of water consumption and medical waste generation. RG Hospitals is working toward improving efficiency in dialysis systems, optimising water usage, and ensuring responsible biomedical waste management.
India now has the second-highest number of chronic kidney disease (CKD) patients globally, with approximately 13.8 crore Indians affected as of 2023, and CKD prevalence rising from 11% to over 16% in recent years. As a nephrologist at RG Hospitals, what do you believe are the primary reasons behind this alarming surge, and why does CKD remain so widely underdiagnosed in India.
India's CKD surge is a perfect storm of metabolic epidemics and lifestyle shifts. Diabetes and hypertension top the list, directly scarring kidney filters (glomeruli) through high blood sugar and pressure. Add obesity, unchecked processed food intake (high in hidden salts and phosphates), and sedentary jobs and kidneys bear the brunt.
Another major issue is late detection. CKD often progresses silently without noticeable symptoms in the early stages. In India, routine preventive health check-ups are still not common, and kidney function tests are rarely done unless symptoms appear. As a result, many patients are diagnosed only when the disease has already reached advanced stages.
CKD is often called a "silent disease" because it can progress without noticeable symptoms for years, and many patients only learn of their condition at advanced stages. What early warning signs should the general public, especially people in Mumbai's fast-paced urban lifestyle, watch out for? How often should high-risk individuals get screened?
Chronic kidney disease is often called a silent disease because symptoms usually appear only when kidney function has already declined significantly (kidneys can lose 50-70% function before symptoms appear). However, early warning signs can include persistent fatigue, swelling in the feet or face, changes in urination patterns, foamy urine, unexplained nausea, or high blood pressure. For individuals with risk factors such as diabetes, hypertension, obesity, or a family history of kidney disease, annual kidney screening is strongly recommended. Simple tests like serum creatinine, urine protein analysis, and blood pressure monitoring can help detect kidney issues early and significantly improve treatment outcomes.
Studies consistently show that diabetes is the leading cause of CKD in India, accounting for roughly one-third of cases, followed by hypertension. Given that India is also the "diabetes capital of the world," what specific advice would you give to diabetic and hypertensive patients to protect their kidneys before damage becomes irreversible?
Diabetes and hypertension remain the leading causes of kidney damage in India. The most important step for patients is strict control of blood sugar and blood pressure levels through medication, lifestyle changes, and regular monitoring.
Patients should maintain a balanced diet with controlled salt intake, adequate hydration, and limited processed foods, along with regular physical activity (45 mins post meals). Periodic kidney function tests should also be a routine part of diabetes management so that any decline in kidney health can be detected early and managed effectively.
There is growing concern that CKD is no longer just a disease of the elderly and is increasingly being seen in younger Indians. What lifestyle factors, such as excessive NSAID use, high-protein fad diets, energy drinks, or sedentary habits, are contributing to kidney problems in the 25–40 age group? What preventive steps should young professionals take?
Kidney disease is increasingly being seen in younger age groups due to several modern lifestyle factors. Excessive use of painkillers (NSAIDs), high-protein fad diets, dehydration, energy drinks, smoking, and sedentary work routines are placing additional stress on kidney function. Young professionals should focus on adequate hydration, balanced nutrition, regular exercise, and avoiding unnecessary self-medication with painkillers. Regular health check-ups are equally important, as early intervention can prevent long-term kidney damage.
This year's World Kidney Day theme, "Kidney Health for All: Caring for People, Protecting the Planet," highlights the environmental impact of kidney disease treatment, particularly dialysis, which is highly resource-intensive in terms of water, energy, and waste. How is RG Hospitals addressing this dual challenge of delivering quality kidney care while reducing the environmental footprint of treatments like haemodialysis?
Dialysis is a life-saving therapy but it is also resource intensive, particularly in terms of water consumption and medical waste generation. At RG Hospitals, we are actively working toward improving efficiency in dialysis systems, optimising water usage, and ensuring responsible biomedical waste management. Additionally, we continue to encourage early detection, preventive nephrology, and kidney transplantation, where appropriate, as these approaches can reduce the long-term dependence on dialysis while improving patients’ quality of life.
The cost of dialysis and kidney transplant remains prohibitively high for a large section of India's population, and public health spending hovers around just 2% of GDP. What policy-level changes or government interventions do you believe are urgently needed to make kidney care more accessible and affordable, particularly for patients from rural and lower-income backgrounds?
Access to kidney care remains a major challenge in India, particularly for patients from rural or economically weaker backgrounds. Expanding government-supported dialysis programs, increasing insurance coverage for kidney treatment, and strengthening public hospital infrastructure are essential steps.
In addition, greater emphasis on preventive healthcare, early screening programs, and awareness campaigns can significantly reduce the burden of advanced kidney disease and lower the overall cost of treatment in the long run.
RG Hospitals has been at the forefront of urology and nephrology care in India for over 38 years. Could you share any recent advancements, in areas such as kidney transplant protocols, home-based dialysis, or AI-assisted diagnostics, that are improving patient outcomes at RG Hospitals? What emerging innovations excite you the most?
Over the years, RG Hospitals has continued to adopt advanced technologies and treatment protocols to improve patient outcomes. These include refined kidney transplant protocols, minimally invasive urological procedures, and expanded dialysis care services designed to provide safer and more efficient treatment. Emerging innovations such as AI-assisted diagnostics, personalised treatment planning, and home-based dialysis models are particularly exciting, as they have the potential to make kidney care more accessible and patient-friendly in the future.
Finally, as we observe the 20th anniversary of World Kidney Day, what is your single most important message for HE's readers — both those who are healthy and those already living with kidney disease — about taking charge of their kidney health in 2026 and beyond?
Kidney health is often overlooked until serious complications arise. My message to everyone is simple: prioritise prevention and early screening. Maintaining a healthy lifestyle, controlling diabetes and blood pressure, staying hydrated, and undergoing routine health check-ups can go a long way in protecting kidney function.Kidney disease is largely preventable and manageable when detected early. Taking small but consistent steps toward healthier living can help ensure better kidney health for years to come.
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