Bangalore, 22 March 2023: NephroPlus, India’s largest dialysis network and a pioneer in redefining dialysis care, and Kidney Warriors Foundation, India’s largest patient advocacy body hosted a panel discussion inviting India’s finest medical experts in the field of Cardiology, Diabetology, Nephrology, and Ophthalmology to address the growing risk of co-morbid diseases such as cardiac illnesses and diabetes on kidney health. The program was organized on the occasion of World Kidney Day under the guidance of the Indian Society of Nephrology and the Indian Medical Association. The focus of the initiative was to set the ball rolling for the early detection and prevention of Chronic Kidney Disease.
The program was graced by the presence of Sri. D. Randeep, IAS and Health Commissioner, Ministry of Health and Family Affairs (Karnataka), Government of India who stated that “awareness and early screening is the key. It helps in keeping people away from ending up with CKD and finally ESRD. The dialysis demand and waiting list for a kidney transplant are alarming. This is a wake-up call for all of us to act now.”
To set the stage for the panel discussion, Dr. Gurudev K C, Chief Guest and President, Nephrology, at Ramaiah Memorial Hospital, highlighted that while clinical management of CKD has been practiced widely, efforts in preventive nephrology with early intervention in people at risk for BP and Blood sugar is the need of the hour.
“Chronic Kidney disease has reached an epidemic proportion, and it is estimated that 10% of the population suffers from it. Unfortunately, most clinicians spend their time in curative nephrology rather than taking preventive measures. India has a massive gap between those who have and have not. Each year more than 100 thousand new cases of renal failure are added, and probably ten times this number goes unreported. Renal replacement therapy, either in the form of dialysis or transplant, is available only for a fraction of this number” added Dr. Gurudev
Chronic Kidney Disease is a burden that is growing in India and worldwide. Diabetes and hypertension are two leading causes of CKD. With good control of diabetes and hypertension, kidney disease can be prevented. And if someone has early kidney disease progression it can be stopped and delayed, so they don’t end up requiring dialysis. We can also prevent a lot of deaths from CKD, just by good Glycaemic control, so good diabetes control and good control of blood pressure are important.
Keeping this in mind, it was discussed that patients with diabetes or hypertension should get their health tests done, get their creatinine or eGFR checked. This will help in determining kidney health. Several drugs are used for blood pressure control and diabetes control, which also protect the kidneys. And some of these medications protect our kidneys even if we don’t have diabetes.
Therefore, consulting the doctor is imperative, because while controlling diabetes and blood pressure, it is also important to save the kidneys.
Speaking on the condition of Hypertension, Dr. Rajan Shetty – Interventional Cardiologist at Manipal Hospital said, “Most cardiologists end up seeing 30 to 40% hypertension cases during OPDs.Therefore, it is very important to tell patients why it is important to treat hypertension. As the treatment is mainly to prevent strokes because 80% to 90% of strokes can lead to kidney disease, heart failure, and many other conditions.”
“Secondary hypertension because of obstructive sleep apnea is also a big issue. This needs to be controlled through the CPAP machine. Uncontrolled secondary hypertension could affect the kidneys, heart, and liver. It is vital to gather information on sleep patterns.” Added Dr. Shetty
Leading Diabetologists, Dr. K N Monohar and Dr. Bhavan on the panel also focused on the fact that diabetes is the leading cause of kidney failure worldwide, and diabetes management should not only focus on controlling blood sugar but also consider other issues like hypertension, high cholesterol, kidney and heart functions, and eye diseases. They called for a shift towards holistic management of diabetes. They also emphasized the need for education on healthy living and regular monitoring of health parameters like weight, blood pressure, blood sugar, and cholesterol values. They suggested that such education should be included in school curriculums.
On the other hand, prominent Ophthalmologists Dr. Santosh and Dr. Dhwani Shah stressed the importance of annual eye check-ups and the use of regional cameras that can detect changes in the retina related to diabetes, hypertension, and glaucoma. The panel agreed that lifestyle changes and education are the most effective “vaccines” against non-communicable diseases like diabetes, hypertension, and obesity
Similarly, renowned Gynaecologists, Dr. Shefalika and Dr. Kavita Kovi stated that It is crucial for young women to be aware of the potential kidney problems that can occur during pregnancy, such as dehydration and hypertensive disorders. Regular check-ups with their obstetrician and prompt reporting of any symptoms like flank pain, recurrent UTIs, or facial swelling can help detect these problems early and prevent serious consequences. Regular ultrasounds can help detect any silent loss of kidney function early, which can be effectively treated to prevent further damage.
Furthermore, CKD patients may experience menstrual disturbances like heavy flow, painful cycles, and prolonged flow, which can be managed with safe medications. It is important to treat these symptoms to prevent anemia, which can worsen the situation in CKD patients. Overall, patient awareness, early detection, and proper treatment are crucial for preserving kidney function in young women with gynaecological problems or pregnancy-related complications.
On the same note, physicians like Dr. Sundar Sankaran, Dr. Anuradha and Dr. Padma also highlighted the importance of the general physician by stating that, the family doctor role has always been largely undermined with multi-specialty taking the limelight. The family doctor who has generations of relationship with the family is ignored. However, they could be the bridge for information between nephrologists and patients. Hence, family doctor needs to guide their patients on appropriate treatment by specialized doctors to avoid critical ailments.