Diabetes-related kidney disease is a rapidly growing crisis in India, affecting millions of individuals and placing a tremendous strain on the healthcare system
Dr. Vaishnavi Pochineni
Diabetes and kidney disease are becoming an increasingly prevalent issue in India. As the number of people with diabetes rises, so too does the incidence of diabetic nephropathy, a leading cause of kidney failure. Dr. Vaishnavi Pochineni, an expert in nephrology and transplant nephrology, discusses about the growing crisis of diabetes-related kidney health in India and how it can be managed effectively.
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Q1: Dr. Pochineni, how is diabetes linked to kidney disease?
Dr. Vaishnavi Pochineni: Diabetes, particularly Type 2 diabetes, is a significant risk factor for kidney disease, specifically diabetic nephropathy. When blood sugar levels are poorly controlled over time, they damage the blood vessels in the kidneys, impairing their ability to filter waste and excess fluids. This leads to a gradual decline in kidney function. Diabetic nephropathy is now one of the most common causes of chronic kidney disease (CKD) and, if left unchecked, can lead to kidney failure or end-stage renal disease (ESRD).
Q2: How prevalent is diabetic kidney disease in India?
Dr. Vaishnavi Pochineni: India is facing a major health crisis with diabetes. Currently, over77 million people are living with diabetes, and about30-40%of these individuals will eventually develop some form of kidney damage. The situation is especially concerning as India also has a high rate of undiagnosed cases of both diabetes and kidney disease, meaning the burden is likely even greater than reported. As diabetes rates rise, the prevalence of diabetic nephropathy is also expected to increase significantly in the coming years.
Q3: What are some of the main reasons why diabetic kidney disease is on the rise in India?
Dr. Vaishnavi Pochineni: There are several contributing factors. One of the key reasons is the lack of awareness about kidney complications among both patients and healthcare providers. Many people with diabetes in India don’t get tested regularly for kidney function, which means kidney damage often goes undetected until it's advanced. Another major factor is lifestyle changes-urbanization, sedentary behavior, unhealthy diets, and high levels of stress have all contributed to a sharp rise in diabetes and, consequently, diabetic nephropathy.
Furthermore, India has a high prevalence of untreated hypertension, which accelerates the progression of kidney disease, especially in people with diabetes. The combination of these factors makes diabetic kidney disease a growing public health concern.
Q4: What are the challenges in managing diabetic kidney disease in India?
Dr. Vaishnavi Pochineni: One of the biggest challenges is the delay in diagnosis. Many people with diabetes don’t undergo regular screening for kidney function, such as urine tests for albumin and blood tests for creatinine. Without early detection, kidney damage can progress unchecked, leading to complications that could have been avoided with timely intervention.
Additionally, the healthcare infrastructure in India, especially in rural areas, remains underdeveloped, which limits access to timely and specialized care. Poor awareness, combined with inadequate healthcare resources, makes it difficult to manage and treat diabetic kidney disease effectively.
Q5: How can diabetic kidney disease be prevented or managed?
Dr. Vaishnavi Pochineni: Prevention and early intervention are key. The most important strategy isc tight control of blood sugar. Keeping blood glucose levels within the target range can prevent or slow the progression of kidney damage. Regular screening for kidney function, including tests for albuminuria and serum creatinine, is crucial for early detection.
In addition to medical treatment, lifestyle modifications are critical. A balanced diet, regular physical activity, weight management, and smoking cessation can significantly improve overall health and help manage both diabetes and kidney health. Reducing salt intake and eating whole, unprocessed foods can also help control blood pressure, which is another major risk factor for kidney damage.
Q6: Dr. Pochineni, what would you recommend for healthcare professionals and policymakers to address this crisis?
Dr. Vaishnavi Pochineni:
There are two key areas where we need to make significant improvements-education and access. First, there is a need to increase awareness among both patients and healthcare providers about the risks of diabetic nephropathy. Regular screening and early detection must be part of the standard care for people with diabetes, and doctors need to be proactive in advising their patients to monitor kidney function.
Second, improving access to healthcare in underserved areas is essential. This includes improving infrastructure, increasing the availability of diagnostic tests, and training healthcare providers to better manage diabetes-related complications.
Public health campaigns aimed at encouraging healthy lifestyle choices and better diabetes management could also play a significant role in preventing diabetic kidney disease. It’s critical that we shift the focus from treatment to prevention, as early intervention can make a huge difference in outcomes.
Q7: What does the future hold for managing diabetic kidney disease in India?
Dr. Vaishnavi Pochineni: If we can improve awareness, access to care, and preventive measures, I’m optimistic about the future. Advances in medical research, including new drug therapies and potential treatments for kidney repair, offer hope. However, the real breakthrough will come when we focus on comprehensive care that includes early detection, lifestyle modification, and better diabetes control. The growing burden of diabetes and kidney disease is a wake-up call, and it’s up to all of us-healthcare providers, policymakers, and the public-to act now before this crisis becomes unmanageable.
Conclusion
Diabetes-related kidney disease is a rapidly growing crisis in India, affecting millions of individuals and placing a tremendous strain on the healthcare system. However, with improved awareness, early detection, and timely intervention, we can prevent or slow the progression of diabetic nephropathy. As Dr. Vaishnavi Pochineni stresses, addressing this issue requires a multi-pronged approach, combining better screening practices, lifestyle changes, and access to quality care to tackle this looming health challenge head-on.
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