A Call for Awareness

World Kidney Day, observed annually on the second Thursday of March, serves as a global platform to raise awareness about kidney health and the growing burden of kidney disease worldwide. This year’s theme, “Kidney Health for All – Caring for People, Protecting the Planet,” highlights an increasingly important dimension of public health. It reminds us that protecting kidney health requires not only better medical systems but also greater attention to environmental conditions, including pollution, rising temperatures, and access to clean water. As the world confronts the twin pressures of lifestyle diseases and environmental stress, kidney health has emerged as a critical area requiring coordinated action.

India today faces a significant and growing challenge when it comes to kidney disease. Medical studies suggest that between 15 and 17 per cent of the adult population may have some form of chronic kidney disease, though many cases remain undiagnosed. Diabetes and hypertension remain the leading causes, gradually damaging the kidneys over time. With India already home to more than 100 million people living with diabetes and a rapidly rising incidence of hypertension, the potential burden of kidney disease is substantial. Each year, it is estimated that nearly 200,000 individuals in India progress to end-stage kidney disease, a condition that often requires dialysis or kidney transplantation for survival. Yet access to treatment remains uneven, and many patients are diagnosed only at advanced stages of the disease.

India has taken important steps in recent years to address this growing health concern. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) plays a crucial role in identifying and managing the underlying conditions that often lead to kidney damage. By promoting early screening and long-term management of diabetes and hypertension at the community level, the programme contributes significantly to kidney disease prevention.

Treatment access has also expanded through the Pradhan Mantri National Dialysis Programme, which provides dialysis services at district hospitals across the country. This initiative has helped improve access to life-sustaining treatment for patients in smaller towns and rural areas who might otherwise struggle to obtain dialysis care. Financial protection has further strengthened through Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, which provides health coverage of up to Rs. 5 lakh per family per year for secondary and tertiary healthcare, including dialysis and kidney transplantation procedures. In addition, Ayushman Bharat Health and Wellness Centres are strengthening preventive healthcare by enabling screening for hypertension, diabetes, and other non-communicable diseases that increase the risk of kidney damage.

Kidney transplants must also form a central pillar of India’s response to advanced kidney disease. While dialysis can sustain life, transplantation offers a far more effective long-term solution, allowing patients to regain better health and quality of life. However, access to transplantation remains limited largely because of the shortage of organ donors. India’s deceased organ donation rate remains below one donor per million population, compared to countries such as Spain, where rates exceed 40 donors per million, and the United States, where they are above 35 per million. Bridging this gap requires sustained public awareness about organ donation, stronger hospital coordination systems, and greater participation in national donor registries. Initiatives led by the National Organ and Tissue Transplant Organisation (NOTTO) are working to improve awareness and streamline transplant networks, but broader community engagement remains essential to ensure that more patients can benefit from life-saving transplants.

While these initiatives represent significant progress, there remains considerable scope to strengthen India’s response to kidney disease. One of the most pressing challenges is improving early detection and timely diagnosis. Because kidney disease often progresses silently, many patients seek medical care only when kidney function has already deteriorated significantly. Expanding routine kidney function testing, particularly for individuals living with diabetes or hypertension, can help detect the condition earlier and slow its progression through timely intervention.

Equally important is improving access and continuity of treatment. Dialysis services, while expanding, remain unevenly distributed across regions, and many patients continue to face barriers in receiving consistent care. Strengthening dialysis infrastructure, ensuring the availability of trained personnel, and reducing out-of-pocket costs can significantly improve patient outcomes. At the same time, expanding transplant infrastructure and strengthening referral systems between primary health centres, district hospitals, and specialised nephrology services will be essential to ensure that patients receive timely treatment and are able to access long-term solutions where appropriate.

Public awareness must also remain a central pillar of the national response. Many individuals remain unaware of the risks associated with kidney disease or the importance of early screening. Community health programmes, workplace awareness initiatives, and public health campaigns can encourage people to monitor blood pressure, manage diabetes effectively, and seek medical advice when needed. Preventive health practices such as balanced diets, adequate hydration, and responsible medication use play a critical role in protecting kidney function over the long term.

The theme of this year’s World Kidney Day also reminds us that kidney health cannot be viewed in isolation from environmental conditions. Rising temperatures, air pollution, and contaminated water sources can place additional strain on kidney function. In several regions globally, prolonged heat exposure and dehydration among outdoor workers have been linked to increasing cases of kidney disease. Environmental toxins and industrial pollutants may also contribute to long-term kidney damage. Protecting kidney health, therefore, requires broader attention to environmental sustainability, occupational safety, and access to clean drinking water.

At the Illness to Wellness Foundation, we believe that addressing kidney disease requires a holistic and forward-looking approach. Preventive healthcare must remain the cornerstone of national health strategies, supported by strong diagnostic systems, accessible treatment infrastructure, and sustained public awareness. At the same time, health policies must increasingly account for environmental factors that influence disease patterns in a changing world.

World Kidney Day offers an opportunity to reflect on the progress that has been made and the work that still lies ahead. Strengthening early detection, expanding equitable treatment access, improving public awareness, and addressing environmental risks must all remain priorities in the years to come. I am confident that by building resilient healthcare systems and promoting responsible health practices, India can significantly reduce the burden of kidney disease and ensure healthier futures for millions of its citizens.

Views expressed are personal. The writer is Chairperson, Advisory Council, Illness to Wellness Foundation