Q: I want to know about the following 1) role of kidney in the proper functioning of the body, 2) impact of Chronic Kidney Diseases (CKD), 3) anaemia situation in India, 4) percentage of people with anaemia due to predominantly vegetarian diet, iron deficiency etc. and impact of CKD on anaemia 5) major challenge for Indian nephrologists.

A:Kidney is a vital organ of the body responsible for cleansing the body of metabolic waste products by removing these through urine. Thus kidney maintains the purity of the internal environment of the body. In addition kidney also secretes various hormones like Erythropoietin (responsible for making red blood cells), activating vitamin D3 (responsible for stronger bones), renin – angiotensin prostaglandins (for blood pressure and salt and water balance) and other hormones. Chronic kidney disease leads to kidney failure requiring kidney transplantation or dialysis as treatment modalities, both expensive treatments, thus not affordable to a vast majority in the country. Approximately 1.5 lakh to 2 lakh individuals require dialysis and transplantation in our country every year, only 3500 transplants are done in a year and not more than 30,000 people are on dialysis thus about 1.25 to 1.65 lakh people cannot afford to get treated or even reach a nephrologist. Kidney disease predisposes to death from heart disease as well as kidney failure. A patient with kidney disease has 10 to 100 fold higher chances of dying from cardiovascular disease like heart attacks, heart failure or stroke. Kidneys synthesise Erythropoietin, which is responsible for red cell growth in the bone marrow, thus patients of chronic kidney disease invariably have anaemia, which can be corrected by recombinant Erythropoietin; now available in the market. Iron deficiency is common in Indian population and needs to be corrected in patients with kidney failure before giving expensive Erythropoietin; now available in the market. Challenge for Indian Nephrologists- Indian nephrologists (only 800 for 1 billion population) have to practice day in and day out fighting financial constraints of patients with kidney disease as the treatments are expensive and morbidity and mortality of the disease is high. The kidney disease has huge impact on financial, social, mental and physical health of patients and their families and Indian Nephrologists practice under these constraints as patients have to pay for these treatments personally in contrast to Govt. funding in the West for these treatments.