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Kidney disorders on steep rise in India with poor insurance cover, shortage of nephrologists
Nandita Vijay, Bangalore | Friday, March 14, 2008, 08:00 Hrs  [IST]

While there is an increasing incidence of chronic kidney disorders (CKD) in India, patients are suffering due to lack of insurance and shortage of nephrologists. There are no centres to diagnose or treat early stage kidney diseases or CKD in the small towns and districts. This has made it extremely difficult for most kidney patients to afford treatment and access medical facilities.
The decision of the medical insurance companies not to support CKD cases and the need for a comprehensive insurance policy which will include kidney diseases is of critical importance. On the World Kidney Day observed on March 13, nephrologists are of the view that it is high time medical insurance providers are concerned about this disease which strikes 1 out of 9 people in the country and is proving to be a serious threat. India is already a diabetic capital and could soon become a hub for CKD, Dr. Gokulnath, professor and head, department of Nephrology, St, John's Medical College and Hospital, told Pharmabiz.
A study in collaboration with the Boston University, US which also involved St. John's Hospital, revealed that 24 per cent of the urban and 17 per cent of rural population suffer from CKD. "Much of these stem from lack of awareness of simple urine test which can detect kidney problems at an early stage and prevent dialysis and transplant. Just as people get tested for diabetes, they must at the same time check for kidney ailment. It is important that the public and the family physician look at periodic tests, averred Dr. Gokulnath.
Nephrology departments conducting dialysis and transplant are only located in the metros. In Karnataka, there are many hospitals offering the two services and St. John's Medical College Hospital has the largest dialysis facility of 29 beds among missionary medical centres in the State. While Mangalore has 3 centres, the remaining are located at Mysore, Belgaum, Hubli and Davangere. At least 23 out of 29 districts have no facility. Going hand-in-hand with lack of nephrology care centres is serious shortage of nephrologists. Currently, India has only 800 nephrologists who treat one lakh new CKD. In the US, which has one third of the India's population has 5 times more nephrologists.
A visible trend is that diabetes is the main cause of CKD in India, unlike the past when Glomerulonephritis, infection and kidney stones were the common causes of the dreaded disease.
In this scenario, an awareness on prevention of lifestyle disorders, control of obesity and smoking is required. There should be regular check-ups for kidney ailments as over 90 per cent cases are diagnosed in the last stages which make it a huge economic burden for the families. Both transplant and dialysis are expensive. A minimum monthly allocation of Rs. 20,000 is required for drugs after transplant and for dialysis. Out of 100 CKD cases, only 50 per cent consult nephrologists of which 40 percent cannot afford and 10 per cent continue drugs. There reaming succumb silently. It is vital to detect cases early so that lifespan can be increased. Most of the patients are breadwinners and affordability is a huge concern, added Dr. Gokulnath.

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