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Premature kidney failure increases in the last decade

More Indians now die of kidney failure than of HIV/AIDS, reports The Hindu’s science correspondent, R.Prasad. This marks a huge shift in the numbers of fatalities over the past decade from infectious disease to non-transmittable chronic disease. In 2015 for example, the deaths associated with AIDS related conditions was 67,600, compared to 136,000 related to kidney failure.

This month a report has been posted in The Lancet charting the increase in deaths related to kidney failure over the last decade in India. In 2015 a Global Burden of Disease (GBD) study indicated kidney failure to be the eighth leading cause of death across India.

The growing number of kidney failure cases over the last decade has been considerable —  86,000 deaths from the disease were recorded in 2003. What is perhaps more concerning is that the age range for renal failure has also seen fluctuation. Even in age ranges under 20 the rates of renal problems have increased.

It has long been documented that Indians are genetically prone to diabetes. Genome Wide Association Studies (GWAS) have uncovered that several genes linked to insulin resistance and diabetes are prevalent in the Indian population. It is thought that this may be the largest contributing factor to the high mortality rates by kidney failure.

Diabetes, if properly treated and lifestyle changes made accordingly can be managed well and a healthy life can still be had. However, undiagnosed or poorly treated diabetes can cause chronic damage to the kidneys which will worsen with time. It is thought that this is the cause of the increased number of associated deaths.

Considering the healthcare infrastructure deficits in India it is worth noting that kidney related issues can often be some of the hardest diseases to manage. Defective kidneys will often require regular dialysis treatments at a hospital, and so are not a condition treatable with medication at home. Total kidney failure may require dialysis between three and five times a week.

Geospatial analysis suggests that 60 percent  of Indians live at least 50km away from a hospital, so for some this dialysis treatment may be an impossibility. This brings about a reliance both on healthcare as well as infrastructure to ensure access to treatments on this kind of a regular basis. Others may be spending out of pocket for this treatment and may simply not be able to afford it.


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