Chronic kidney disease is becoming a major public health problem. Although the disease causes premature death and disability, it has received less attention than other non-communicable diseases.
As per a recent estimate, more than 750 million people are affected by chronic kidney disease across the world – more than 130 million of them are in India. Why is such a major cause of mortality not prioritized in national policy?
National statistics in India often mask an important fact: chronic kidney disease burden is not the same in all states. Some states experience much higher disease burden, mortality and disability than other states.
Do we need state level policies to address this issue?
To understand the status of chronic kidney disease in India, researchers from the Institute of Liver and Biliary Sciences and Fortis Hospital, New Delhi analysed the data in the Global Burden of Disease 2023 database.
They found that, while age-standardised rates declined nationally from 1990 to 2023, the total number of cases remains high and is increasing. The disease is not disappearing but shifting into a long-term chronic crisis due to population aging.
To compare and contrast the state level statistics of chronic kidney disease, the researchers calculated the estimated annual percentage change for every state. The states were thus clustered into high-burden with increasing trend and low-burden with decreasing trend. The difference between the two categories was high. In 2023, mortality in Telangana was three times higher than that in Rajasthan. Punjab and Telangana remained high-burden clusters despite national improvements.
Is the disease burden heavier in disadvantaged populations?
To check, the researchers used the socio-demographic index and concentration indices.
They found a significant inequality for mortality. Wealthier states like Kerala and Tamil Nadu have high prevalence, but lower mortality because of better health systems. In poorer states, chronic kidney disease translated directly into disability and premature death.
Chronic kidney disease remains a major health challenge in India. The overall disease burden remains high. Since there are inequalities between states, India needs state-specific strategies rather than a single nationwide approach.
Early screening for diabetes and hypertension, leading causes of chronic kidney disease, is important. Improving early diagnosis and ensuring equal access to kidney care, including better access to dialysis and transplantation, need to be prioritised in disadvantaged states.
Indian J Med Res 163: 810-818 (2026);
DOI: 10.25259/IJMR 3182 2025
Reported by Aritha Chandrasekar
Sastra Deemed to be University, Thanjavur
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