With changing environment and practices, even the health dynamics has changed in past years. The days fighting communicable diseases are far left behind. Indian healthcare fought hard to control diseases like polio but now faces the new challenge of chronic lifestyle diseases that have been on a steep rise especially in the urban India. This new threat comprises of simple sounding but very chronic ailments like diabetes, hypertension, obesity, cardiovascular problems to count a few.
With a lot of awareness already doing a buzz on social media since some years, globally, people have become a tad cautious of a particular lifestyle demerit. But in India, we still lag behind in understanding the larger and dire consequences of such, not so seemingly fatal lifestyle issues. One of these consequences is Chronic Kidney Disease commonly referred to as CKD in the medical lingo.
CKD basically means lasting damage to the kidneys that can get worse over time. If the damage is severe, the kidneys may stop working. This is called kidney failure, or End-Stage Renal Disease (ESRD). If your kidneys fail, you will need dialysis or a kidney transplant in order to live which is a difficult situation altogether. Still a new term for many health conscious individuals; CKD, is a silent and uninvited guest on a high rise especially in India.
An important question is; who can have CKD? Sadly, the answer is — Anybody. But you are at a higher risk if you are diabetic, Hyper tensioned, obese or have a heart condition. A common misconception amongst people is that Kidney related diseases can only happen to drunkards or obese. Here are some facts to break some common myths.
• 60% of the patients suffering from chronic kidney diseases in India are either diabetic or suffer from high blood pressure.
• 67 million Indians have Type 2 Diabetes
• 30–40% patients with Diabetes mellitus may turn into a CKD patient
• 139 million Indians have uncontrolled hypertension
• 14–22% patients with Hypertension may turn into a CKD patient
So you think you might be healthy or just be plain diabetic. But the fact is you are extremely susceptible to kidney degeneration.
CKD caused by Diabetes is called Diabetic Nephropathy. Diabetic nephropathy is basically the damage to your kidneys caused by diabetes. In severe cases it can lead to kidney failure. The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar from diabetes can destroy these blood vessels. Over time, the kidney isn’t able to do its job as well. Later it may stop working completely and hence kidney failure. India being the Diabetic hub of the world, one can imagine the rampant and latent vulnerability of Indians to CKD.
The most treacherous side of this disease is that it usually has no significant symptoms until it has reached later stages where a patient is not left with good options of life. Elaborately, CKD has 5 stages. Patient in stage 1 to 3 can be treated with medicines and live a routine life. But stage 4–5 leaves the patient with options of dialysis or kidney transplant which are not only taxing on the life but also on the pocket. Thus it becomes crucial to detect CKD at early stage and have a scope of treatment and a good life
Let’s have a glance at the prevalence of CKD.
• Globally: The estimated prevalence of CKD is 8–16% in adults over the age of 30 years as per World Health Organization.
• USA: More than 10% of people, aged 20 years or older in the United States have CKD.
• Europe: More than 10% of the population suffers from chronic kidney disease (CKD)
• UK: In 2013 overall prevalence of CKD was found to be 6.76%
• China: Reported prevalence of CKD ranges from 11.0 to 13.0% depending on geography. • In India the prevalence is alarming at 17.2% in urban population.
The total population of India stands at around 125 crore with almost 60 crore of the population above 30 years of age. If we compare and consider the least alarming figure of regions like U.S.A and Europe (aforesaid) and consider the same for India, then 10% of 60 crore i.e. at least 6 crore Indians might be presently suffering from CKD. Moreover, it is estimated that only 6–7 lakh patients have been diagnosed in India with CKD. That means only 1% of the affected population is diagnosed. 99% are still untraced and are or about to suffer from end stage kidney disease. This is severe and an extremely grim scenario.
So CKD is at the brink of turning into an EPIDEMIC if no-diagnosis situation continues due to lack of awareness in India. The query that pokes us is what do we do as individuals? Answer is simple. If you are above 30, get yourselves tested for CKD. In consultation with your physician or preferably a nephrologist, undergo these tests once a year despite of being healthy in your own terms. In case you are suffering from Diabetes or Hyper tension or you have a history of diabetes in your family, you should definitely get tested at the earliest. These tests can be done at any nearby pathology lab and are not extensively costly either. Ideally, these should be a part of routine or the annual body checkups.
1. eGFR (estimated Glomerular Filtration Rate)
2. Urine Protein
3. Urine Albumin to Createnine Ratio
5. Serum Phosphorous
6. Blood Urea Nitrogen
• The Lancet — Vol 382;Isuue 9888
• National Chronic Kidney Disease Fact Sheet- CDC 24/7 • European Kidney Health Alliance
• BMC Nephrology 2013- 14:9
• BMC Nephrology 2013- 14:253
• BMC Nephrology 2013- 14:114
• Journal of pharmacy and bio-allied science 2012- volume 4:2:107–111
• March 15, 2013 | Pratibha Masand , TNN