With kidney disease affecting close to one-fifth of India's population, late diagnosis and limited access to treatment are turning it into a silent epidemic. Experts stress the need for early screening and better awareness.

As the morning sun streamed through the window of a dialysis ward in a Delhi hospital, patients shifted uncomfortably in their chairs, adjusting the catheter in their arm. The steady hum of machines filled the room, a constant reminder that their lives had changed forever. Just a year ago, many of them were busy running businesses, managing households, and planning for their families' futures. But now, three days a week, they spend hours hooked to dialysis machines, fighting a battle they never saw coming—chronic kidney disease (CKD), a silent epidemic creeping into millions of Indian households.

On World Kidney Day, experts warn that kidney diseases are rising at an alarming rate in India, with nearly 17% of the population affected, according to a study published in the Indian Journal of Nephrology. Yet, awareness remains dangerously low.

Late Diagnosis: A Hidden Danger

"Most people don’t realize 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, Nephrology & Kidney Transplant Medicine, Asian Hospital, explains, "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 the health conditions gradually damage the kidneys without causing symptoms in the early stages of CKD. 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 his legs—but they never link them to kidney disease.

Heart-Kidney Connection

"The kidneys and heart are deeply interconnected, working like two sides of the same coin. When the kidneys fail, excess fluid and toxins build up in the body, forcing the heart to work harder. This added strain can lead to high blood pressure, heart failure, and a significantly higher risk of strokes and heart attacks," Dr. Soubeer Ghosh, Consultant, Nephrology and Kidney Transplant Medicine, PSRI Hospital emphasized the connection between the 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.

The Way Forward--Prevention & Better Management

This World Kidney Day, doctors urge people to get tested, manage their diabetes and hypertension, and adopt kidney-friendly habits—drinking enough water, reducing salt intake, and avoiding over-the-counter painkillers that harm the kidneys.

"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.