'Referral To Nephrologist In Early Stages Of Kidney Disease Is Of Paramount Importance'

EHM News Bureau - Mumbai

April 18, 2006

With 57 million Chronic Kidney Disease patients projected in 2025 from the 19 million in 1995, 15 million to 20 million CKD patients can be prevented at a low cost, if detected early

With India predicted as the kidney disease capital of the world, nephrologists from the city and the country came together for the first time to celebrate World Kidney Day. The Mumbai Nephrology Group and the National Kidney Foundation joined hands to increase awareness about kidney disease.

Said Dr Ajay Singh, Consultant Nephrologist, Harvard Medical School, US, "With an alarming rate of 57 million Chronic Kidney Disease (CKD) patients projected in the year 2025 from the 19 million in 1995, 15 million to 20 million CKD patients can be prevented at a low cost, if detected early."

Nephrologists advocated the need for public awareness programmes with the aim of identifying stage '0' patients and instituting proper intervention. Stage '0' implies people suffering from diabetics, hypertensives, those with kidney stones and infections, high risk pregnancies, have had acute renal failure, senior citizens, those habitually using nephrotoxic drugs like pain killers, arthritis medicines, ayurvedic bhasmas, higher antibiotics, and X-ray contrast dyes, etc.

According to Dr Vidya Acharya, Founder Member, The Maharashtra Confederation For Organ Transplantation (MCFOT), "The population of patients suffering from CKD is increasing and almost 10 per cent of the adult population is estimated to be already suffering from CKD."

Said Dr A L Kirpalani, Consultant Nephrologist, Bombay Hospital, "The individual citizen, the medical fraternity, the social organisations and the NGOs, the insurance and Third Party Administrators (TPAs) can ill afford to ignore the menace of CKD. Ignorance about kidney disease is universal. What is shocking and unforgivable is the ignorance of the medical fraternity, which is unacceptable."

In an attempt to overcome this deficiency in diagnostic armamentarium, the disease is now classified into five stages. "We have formulae like the Cockroft and Gault formula which use the patient's age, sex, and race variable and derive the estimated kidney efficiency from the serum creatinine value (eGFR). These formulae help to recognise early kidney dysfunction i.e., Stage 1 and Stage 2 of CKD," informed Dr Kirpalani.

"Insurance coverage is hardly ever available for this disease and only the Central Government and Railways along with a few philanthropic private employers like the Tatas, the Birlas and the Ambanis pick up the tab for this care. For most others, this disease spells either physical doom or financial disaster. Not more than five per cent of the one lakh new Indian cases per year actually get dialysis or kidney transplant. The other 95 per cent suffer and perish," he added.

In the US, where the government gives free dialysis and kidney transplant to its citizens, 25 per cent of the ESRD patients die without dialysis and kidney transplantation. Experts pinpoint that there is a need for early detection of CKD in Stages 1 and 2, the stages at which reversibility and control are most feasible by community detection projects like 'SEEK' (Screening Early detection and Evaluation of Kidney disease).

Former Prime Minister of India V P Singh was the chief guest of the function and Bollywood actor Shammi Kapoor was the Guest of Honour.

Copyright © 2001 Indian Express Newspapers (Mumbai) Limited (Mumbai, India).

This article posted May 21, 2006.