Chronic Kidney Disease (CKD) is a condition where your kidneys gradually lose their ability to filter waste and excess fluids from your blood. This happens over months or years, and if it worsens, it can lead to kidney failure, requiring dialysis or a transplant. The kidneys are vital organs that clean your blood, balance fluids, and help control blood pressure, so when they don’t work well, it affects your whole body.

 

CKD can be caused by various factors, often a mix of health conditions or lifestyle issues. The most common causes include:

 

•Diabetes: High blood sugar damages the tiny filters in your kidneys over time. In India, diabetes is a major cause, contributing to nearly 45% of kidney failure cases.

•High Blood Pressure (Hypertension): This strains the blood vessels in the kidneys, making them less effective. It accounts for about 20% of CKD cases in India.

•Glomerulonephritis: Inflammation of the kidney’s filtering units, often due to infections or immune system problems.

•Other Causes: Kidney infections, blockages (like kidney stones), genetic conditions (e.g., polycystic kidney disease), and long-term use of certain medications (e.g., painkillers) can also lead to CKD.

•India-Specific Factors: Poor access to clean water, infections, and exposure to toxins (e.g., in certain rural areas like Andhra Pradesh) may contribute to higher CKD rates.

 

In India, many patients don’t notice CKD until it’s advanced because early symptoms are rare, and screening isn’t always routine.

 

CKD is divided into five stages based on how well your kidneys filter blood, measured by the estimated Glomerular Filtration Rate (eGFR), a number calculated from a blood test. Here’s a simple breakdown:

 

•Stage 1: eGFR ≥ 90 (normal kidney function, but with signs of damage, like protein in urine). You may feel fine.

•Stage 2: eGFR 60–89 (mild loss of function). Still no major symptoms.

•Stage 3: eGFR 30–59 (moderate damage). You might feel tired, have swelling, or notice changes in urine. Split into 3a (45–59) and 3b (30–44).

•Stage 4: eGFR 15–29 (severe damage). Symptoms like fatigue, swelling, and itching get worse.

•Stage 5: eGFR < 15 (kidney failure). Waste builds up, and you may need dialysis or a transplant to survive.

 

In India, studies show about 17% of people have CKD, with around 6% in Stage 3 or worse by the time it’s detected, often because awareness and early testing are low.

 

Early CKD often has no symptoms, but as it progresses, you might notice:

 

•Tiredness or low energy

•Swelling in legs, hands, or face (edema)

•Frequent or painful urination

•Itchy skin

•Shortness of breath

•High blood pressure that’s hard to control

 

If you have diabetes or hypertension and notice these, talk to your doctor about a kidney check.

 

Managing CKD aims to slow its progression, ease symptoms, and prevent complications like heart disease. Here’s how it’s done, with tips relevant to India:

 

•Tests: A blood test (for creatinine to calculate eGFR) and a urine test (for protein or albumin) can spot CKD early. In India, only about 1 in 5 people at risk get screened regularly due to limited awareness and access.

•Action: If you have diabetes, hypertension, or a family history of kidney issues, ask for a “Kidney Health Check” at your local clinic.

 

•Diet: Eat a kidney-friendly diet—low salt, moderate protein (e.g., 0.8 g per kg of body weight daily), and less processed food. In India, avoid excess salty snacks like namkeen and limit red meat. Include fruits like papaya and guava (if potassium levels allow).

•Exercise: Stay active with 30 minutes of walking most days to control blood pressure and sugar.

•Quit Smoking/Alcohol: These harm your kidneys further.

•Water: Drink enough water (unless restricted by your doctor), especially in India’s hot climate, but avoid sugary drinks.

 

•Blood Pressure Control: Drugs like ACE inhibitors or ARBs protect your kidneys and lower blood pressure.

•Diabetes Management: Keep blood sugar in check with medicines or insulin.

•Other Drugs: You might need medicines for swelling, anemia, or bone health as CKD advances.

•India Note: Generic medicines are widely available and affordable, but always consult a doctor—don’t self-medicate with over-the-counter drugs like painkillers, which can worsen CKD.

 

•Dialysis: Filters your blood when kidneys fail. Options include hemodialysis (at a center or home) or peritoneal dialysis (using your abdomen). In India, over 100,000 people start dialysis yearly, but access is limited in rural areas.

•Kidney Transplant: Replacing your kidney with a donor’s. It’s the best long-term option, but waiting lists are long, and costs can be high (₹5–20 lakh, though some government schemes help).

•Conservative Care: For those who can’t or don’t want dialysis/transplant, focus shifts to comfort and symptom relief.

 

•Regular check-ups with a nephrologist (kidney specialist) are key. In India, urban areas have more specialists, but rural patients may need to travel.

 

•Prevalence: Around 17% of Indians have CKD (SEEK-India study), higher in states like Andhra Pradesh, Goa, and Odisha.

•End-Stage Kidney Disease (ESRD): The rate is 229 per million people, with over 100,000 new cases yearly needing dialysis or transplant.

•Awareness: Most patients find out late—73% are diagnosed when eGFR is below 15 (Stage 5)—due to low screening rates.

•Access: Only 1 in 4 ESRD patients gets proper treatment due to cost and lack of facilities, especially in rural areas.

•Cost: Treating CKD costs India billions yearly, with dialysis at ₹30,000–45,000 monthly if not subsidized.

 

•Get Tested: If you’re at risk (diabetes, hypertension, age over 60), insist on a kidney test yearly.

•Ask Questions: Talk to your doctor about your stage, diet, and treatment options.

•Seek Support: In India, organizations like the National Kidney Foundation offer resources, and government programs like PMJAY may cover some costs.

•Stay Positive: With proper care, many live well with CKD for years.

 

CKD is manageable, especially if caught early. In India, the key is awareness and action—don’t wait for symptoms to act!