The Hindu : Kerala / Thiruvananthapuram News : `Kidney diseases assuming epidemic proportions'

Online edition of India's National Newspaper
Thursday, Mar 08, 2007
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Kerala

Kerala - Thiruvananthapuram

`Kidney diseases assuming epidemic proportions'

C. Maya

Indiscriminate use of drugs a prime reason: nephrologists

THIRUVANANTHAPURAM: Chronic kidney diseases (CKD) have begun to assume epidemic proportions in the State as a result of the haphazard management of diabetes and the rising incidence of hypertension, nephrologists have warned.

More recently, the indiscriminate use of drugs, including Ayurvedic drugs, has also emerged as one of the prime reasons for the increasing prevalence of CKD.

The State can no longer afford to ignore the increasing proportion of people developing chronic kidney diseases, considering that the treatment of nephrotic diseases are expensive and that renal replacement therapy such as kidney transplantation is inaccessible to most of the patients, says A. Vimala, Professor of Nephrology at Kottayam Medical College.

"We have a large diabetic population but few are aware that lack of glycaemic control (fluctuating blood sugar levels) and diabetes that is not properly treated can damage the kidneys. Elevated blood pressure levels are also treated lightly by most people even though it can directly lead to kidney damage. Unfortunately, the symptoms do not manifest till about 70 per cent of the kidney function has already deteriorated and very little can be done for the patient," she says.

It is time that regular screening programmes at the community level for increased blood pressure and serum creatinine levels were organised so that the susceptible population can be identified and put on early treatment, it is pointed out.

In 2006, the International Federation of Kidney Foundations and the International Society of Nephrology had decided to observe the second Thursday of March every year as World Kidney Day to give more awareness to people about chronic kidney diseases. The message this year is `CKD is Common, Harmful but Treatable.' The emphasis thus is on early detection and prevention through simple routine tests for proteinurea and serum creatinine occasionally.

The prevalence of CKD in India is estimated to be 5 to 10 per one lakh of the population. Once the kidneys are damaged, the disease progresses to End Stage Renal Disease (ESRD) and the patient will require either life-long dialysis or a kidney transplant.

However, only one or two per cent of patients in the country can afford the recurring expenses of both treatment options. Of the one lakh patients who reach the end-stage disease every year in India, only 9,000 are started on dialysis. Out of this, 60 per cent drop out and 20 per cent die owing to inadequate dialysis.

In Thiruvananthapuram Medical College, at least 40 patients are on maintenance dialysis every month and another 40 to 50 on the waiting list. At least two kidney transplants are done every month. Doctors report that the survival period of those on dialysis is rarely more than three years. At least 100 new cases of kidney diseases, which could progress towards end-stage disease, turn up every month here.

The prevalence of hypertension in the adult population in the city is estimated to be 30 per cent in the adult population and of this, only 50 per cent are aware of their condition. Hypertension, remains more or less asymptomatic through out and hence, it is important that the susceptible population — obese individuals and those with a family history of hypertension — is identified and treated early. Hypertension, like diabetes is chronic and requires lifelong treatment, but patients often discontinue treatment on their own as soon as their blood pressure levels normalise

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