Kidney disease rarely announces itself with dramatic fanfare. There's no sharp pain, no urgent warning bells. It operates in stealth mode, quietly causing damage over years until the consequences become impossible to ignore. By the time symptoms become noticeable, the situation has often progressed to a serious stage, making early detection and prevention absolutely critical.
The Global and Indian Kidney Health Crisis
Globally, the numbers paint a concerning picture. In 2023, an estimated 788 million people aged 20 years and older were living with chronic kidney disease (CKD), a staggering increase from 378 million back in 1990. The situation in India is even more alarming, with estimates suggesting that tens of millions of Indians are currently living with some form of kidney disease, many of whom remain completely undiagnosed. This represents a massive public health crisis unfolding right before our eyes, yet receiving insufficient attention.
Primary Culprits: Diabetes and Hypertension
Two of the biggest drivers of kidney failure worldwide are diabetes and high blood pressure. India is home to over 100 million people diagnosed with diabetes, with countless more suffering from undiagnosed hypertension. When blood sugar and blood pressure levels remain poorly controlled over extended periods, they gradually damage the delicate blood vessels within the kidneys. This damage accumulates silently over years and decades, not weeks, making regular monitoring essential for at-risk individuals.
Despite these risks, most people give little thought to their kidney health until problems arise. To understand this silent epidemic better, we spoke with Dr. Vikram Kalra, a Consultant Nephrologist at CK Birla Hospital in Delhi. He explained why kidney disease earns its ominous nickname and how Indians can protect themselves.
Why Kidney Disease is Called a 'Silent Killer'
Dr. Vikram Kalra: "Kidney disease is termed the 'silent killer' because it typically develops without any obvious symptoms during its initial stages. By the time clear warning signs emerge—such as swelling in the extremities, persistent fatigue, or decreased urine output—approximately 70 to 80 percent of kidney function may already be lost. This delayed symptom presentation is what makes it so dangerous."
Early Warning Signs Commonly Ignored in India
Dr. Vikram Kalra: "The early symptoms of kidney disease are often subtle and easily dismissed. People frequently attribute them to general tiredness, stress, or the demands of daily life. These overlooked signs include frequent urination at night, unexplained fatigue, swelling in the feet or face, foamy urine, loss of appetite, and persistent nausea. Recognizing these signals early can be life-saving."
The Rising Tide of Kidney Problems Among Younger Indians
Dr. Vikram Kalra: "The rapid increase in kidney issues among younger populations in India is primarily fueled by uncontrolled diabetes, hypertension, the obesity epidemic, sedentary lifestyles, excessive salt consumption, and the widespread misuse of over-the-counter painkillers. Additional factors like chronic dehydration, rising stress levels, and delayed health check-ups are pushing kidney disease into progressively younger age groups."
Early Detection Through Simple Tests
Dr. Vikram Kalra: "Yes, simple blood and urine tests can detect kidney disease at an early, more manageable stage. Key tests include serum creatinine, estimated glomerular filtration rate (eGFR), and tests for albuminuria. High-risk individuals—those with diabetes, hypertension, or a family history of kidney disease—should undergo testing every six months. For the general population, annual screening is recommended starting from age 30 to 35."
Optimal Hydration for Kidney Health
Dr. Vikram Kalra: "For healthy adults, the recommended daily water intake generally falls between 2.5 to 3 liters, though this should be adjusted based on climate, activity level, and individual health status. Proper hydration supports the kidneys in flushing out toxins. However, overhydration should be avoided, particularly in individuals with pre-existing kidney or heart conditions."
Managing Early-Stage Kidney Disease
Dr. Vikram Kalra: "While existing kidney damage is typically not reversible, early-stage kidney disease can often be halted or its progression significantly slowed. Key strategies include maintaining strict control over blood sugar and blood pressure, implementing appropriate dietary changes, adhering to prescribed medications, and undergoing regular monitoring. These measures can prevent further deterioration and help avoid kidney failure."
Top 5 Preventive Steps for Every Indian
- Strictly control diabetes and blood pressure through medication, diet, and lifestyle management.
- Reduce intake of salt and processed foods to lower the risk of hypertension and kidney strain.
- Stay adequately hydrated by drinking sufficient water throughout the day to support kidney function.
- Avoid unnecessary painkillers and self-medication, as many common drugs can harm kidneys with prolonged use.
- Get annual kidney function tests, especially if you are over 30 or have risk factors like diabetes, high BP, or a family history.
The uncomfortable truth is that kidney disease operates in silence, but silence does not equate to safety. Most people fail to see it coming simply because they haven't been taught to look for it. A simple blood test, a routine urine analysis, and regular monitoring—particularly for those with diabetes, hypertension, or a family history—can catch potential problems early, enabling timely intervention and better health outcomes.
Medical experts consulted: This article includes expert insights shared with TOI Health by Dr. Vikram Kalra, Consultant Nephrologist at CK Birla Hospital, Delhi. His inputs were instrumental in explaining the dangers of kidney diseases and outlining effective prevention strategies.
