Context:

According to the Global Burden of Disease (GBD) 2023 study published in The Lancet, India had the second-highest number of Chronic Kidney Disease (CKD) cases globally - about 138 million people, second only to China (152 million).

About Chronic kidney disease:

Chronic kidney disease (CKD) is a progressive condition where the kidneys become damaged and lose their ability to filter waste and excess fluid from the blood. 

Key Findings of the Study:

• • Global Burden: CKD was the ninth leading cause of death worldwide in 2023, responsible for nearly 1.5 million deaths.
  • Regional Prevalence:
    • North Africa & Middle East: ~18%
    • South Asia: ~16%
    • Sub-Saharan Africa & Latin America: ~15%
    • India: 138 million cases (second globally).
  • CKD and Heart Disease: CKD contributed to 12% of global cardiovascular deaths, ranking as the 7th leading cause of heart-related mortality, ahead of diabetes and obesity.

Major Risk Factors Identified:

The study identified 14 key risk factors, with the following as the most significant:

1.       Diabetes mellitus

2.      Hypertension (high blood pressure)

3.      Obesity

4.     Dietary risks: low fruit and vegetable intake, high sodium consumption

5.     Poor access to healthcare and screening

Other contributing factors include aging population, environmental toxins, and lifestyle changes.

India’s specific Challenge:

• • India’s 16% prevalence rate reflects rising non-communicable diseases (NCDs) and limited screening for early-stage CKD.
  • Most CKD cases are detected late, often requiring dialysis or kidney transplantation, which remain costly and inaccessible to large sections of the population.
  • The public health infrastructure for CKD diagnosis and management is uneven, especially in rural areas.

Policy Implications and Recommendations for India:

The researchers emphasize that CKD needs to be treated as a major non-communicable disease, similar to diabetes and cardiovascular disorders.
Key strategies include:

1.       Early Screening & Prevention: Routine kidney function tests for high-risk groups (diabetic and hypertensive patients).

2.      Public Awareness Campaigns: Promote healthy diets and low-salt consumption.

3.      Affordable and Equitable Care: Expand access to dialysis and transplant facilities under public health schemes.

4.     Primary Healthcare Strengthening: Integrate CKD management in Ayushman Bharat – Health and Wellness Centres (HWCs).

Conclusion:

The GBD 2023 findings are a wake-up call for India’s health policy. Addressing CKD requires a shift from curative to preventive care, integrating screening, lifestyle interventions, and affordable treatment. Without early action, chronic kidney disease could emerge as one of India’s most pressing public health crises in the coming decades.