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India's rising burden of lifestyle diseases is affecting kidney health
This article is authored Dr Ajay Aggarwal, consultant, urology, RG Hospitals, New Delhi.
India's fight against lifestyle diseases has moved well beyond diabetes and heart disease. There is a quieter crisis growing alongside them, one that doesn't get nearly enough attention: Chronic kidney disease (CKD). More people in India are now progressing to dialysis and kidney transplants than at any previous point in time. What makes this especially concerning is that kidney damage tends to build up slowly over many years, often without any clear warning signs. By the time a person feels something is wrong, the disease has frequently already reached a serious stage. This reality alone makes awareness and early preventive care absolutely critical.
The numbers tell a sobering story. A global study published in The Lancet found that India had the second-highest number of people living with CKD in 2023, with around 138 million cases recorded, trailing only China. These figures make clear that CKD has become one of the fastest-growing non-communicable diseases in the country and one that urgently deserves more public attention than it currently receives.
The kidneys are packed with millions of tiny blood vessels whose job is to continuously filter waste and extra fluid out of the blood. When conditions like diabetes and high blood pressure go unmanaged over years, these fragile vessels take a steady beating and gradually lose their ability to function as they should.
The pattern tends to follow a familiar path. Sitting too much leads to weight gain, which raises the chances of developing diabetes and high blood pressure. Those conditions then slowly wear down the kidneys, and if nothing is done, the result can be advanced kidney disease requiring lifelong dialysis or a transplant. High blood sugar, high blood pressure, and excess body weight are consistently among the top drivers of kidney disease worldwide.
CKD has earned the label of a ‘silent killer’ for good reason. In its earlier stages, most people feel perfectly fine, which allows the disease to advance without anyone realising it.
Signs like swollen feet or face, constant tiredness, foamy or blood-tinged urine, frequent night-time urination, poor appetite, nausea, or blood pressure that becomes harder to manage usually only show up after a significant portion of kidney function has already been lost. Waiting for symptoms is, therefore, a risky approach. Screening early remains the most reliable way to catch kidney disease before the damage becomes permanent.
While diabetes and high blood pressure continue to be the primary culprits, several habits common to modern Indian life are adding to the problem. Growing obesity rates, heavy consumption of salty and sugary processed foods, desk-bound routines, chronic stress, poor sleep, smoking, alcohol use, not drinking enough water, and the casual overuse of painkillers bought without a prescription can all chip away at kidney health over time.
Environmental factors are drawing increasing concern as well. Heat exposure and repeated dehydration, particularly for farmers and people working outdoors, along with pesticide exposure and heavy metal contamination in drinking water, have been identified as additional contributors to kidney disease in specific parts of the country.
What is perhaps most worrying is how younger Indians are becoming increasingly vulnerable. Earlier onset of type 2 diabetes, rising rates of childhood obesity, long working hours, heavy dependence on ultra-processed foods, high consumption of sugary drinks and energy beverages, unsupervised use of gym supplements, and the tendency to put off health check-ups mean that kidney disease is no longer something only older adults need to worry about.
Because CKD rarely signals its presence in the early stages, regular screening is essential, particularly for those at higher risk. People living with diabetes, high blood pressure, or obesity, those over 40, and anyone with a family history of kidney disease should have their kidney health assessed every year.
Basic tests including serum creatinine, estimated glomerular filtration rate (eGFR), and urine albumin, alongside routine blood pressure and blood sugar checks, can reveal kidney damage well before any symptoms develop. Catching the disease early creates a genuine opportunity to slow or even stop its progression through proper treatment and changes in daily habits.
The hopeful side of this picture is that a large share of chronic kidney disease cases can be prevented or meaningfully delayed. Controlling blood sugar and blood pressure, keeping weight in a healthy range, cutting back on salt, staying active, drinking enough water, avoiding smoking and heavy drinking, and not reaching for painkillers without proper guidance all go a long way in protecting the kidneys. Routine health check-ups matter even more for those who already have known risk factors.
Kidney disease is largely preventable, yet catching it in time remains the biggest hurdle. By making healthier choices and not postponing routine screening, many people stand a real chance of avoiding not just the physical and emotional weight of advanced kidney disease, but also the considerable financial burden that dialysis and transplants bring. As lifestyle diseases continue to tighten their grip on India, kidney health must be treated as a central part of preventive care, not something addressed only after the damage is done.
(The views expressed are personal)
This article is authored Dr Ajay Aggarwal, consultant, urology, RG Hospitals, New Delhi.
