Dr Sanjiv Saxena, Head of Department, forNephrology & Renal Sciences, PSRI, filters histhought on the kidney scenario in India. He shareshis concern with Shahid Akhter, ENN

Kidney disease has assumed worrisome proportions in India. Why so?
Kidney is a late entrant by way of awareness as well as healthcare approach. Its stoic nature makes it appear less potent but in reality it is just another life-threatening disease. Ten percent of the Indian population is said to be suffering from chronic kidney disease. High blood pressure and diabetes impact kidneyand no less than 60 percent of kidney patients suffer either from diabetes or high blood pressure. All this is attributed to lifestyle changes, preference for fast food and sedentary life and to some extent genetic factors.

There are just 1,000 nephrologists in India . Why do we have such a poor build up in this vertical?
A decade back, there were around 200 cardiologists and there were fewmedical students willing to take up nephrology. Medical fraternity was lured by the heart and there were few takers for the nondescript kidney. It was never appreciated and therefore was less popular as a separate entity. Besides financial constraints and lack of awareness, the prevailing infrastructure is inadequate. Good treatment centres are to be found only in the metro cities with dialysis centres that are few and far.

Is it true that symptoms associated with kidney problems appear very late and this complicates the treatment?
The kidneys are ever busy and equally silent workers. We dont take notice of kidney problems, until they are damaged and by the time kidney problems manifest themselves, it is usually too late. Once there is kidney failure, it is incurable. Lack of awareness leads to ignorance about prevention and timely assistance, which is very crucial.

Why only 2-3 percent of kidney failure patients in India get treated. Has anything been done to improve this scenario?
Kidney treatment by way of transplant or dialysis is expensive. It incurs huge costs and we need to think of ways to lower them. In the US, 80 percent of the cost is governments responsibility. Also there is health insurance. We too need to wake up before it is too late.

What are the technological advancements most recently introduced in renal care at PSRI?
PSRI hospital is one of kind and a pioneer in nephrology. We have a stateof- the-art Dialysis Unit. We have 22 dialysis stations which run in shifts, round-the-clock. We also have provision for portable dialysis. On an average, 50- 70 patients are dialysed daily. We have a well organised organ transplant programme as well.

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