Indian Perspective of World Kidney Day 2024-Kidney Health for All: Advancing Equitable Access to Care and Optimal Medication Practice

Lack of Awareness for Kidney Health:

There is lack of awareness regarding kidney health among population as well as health care providers. There is poor utilization of eGFR (estimated glomerular filtration rate) and urinalysis (albuminuria or microscopic hematuria) testing by primary healthcare providers and physicians, even in high-risk individuals leading to missed diagnosis. There is lack of knowledge for kidney disease risk factors (comorbidities, environmental, low birth weight, pre-eclampsia, etc.). Furthermore, receiving incorrect advice from the quacks causes delayed primary contact with qualified healthcare provider.²

Shortage of Frontline Healthcare Workers:

As for all illnesses, for CKD, prevention is the key. India faces a shortage and lack of training or proper utilization of community-facing frontline healthcare workers who can identify and act at earlier stages of CKD by using pre-defined protocols under regional medical supervision. Also, as most kidney professionals practice in metropolitan cities, this shortage is acute in rural areas and even in third-tier cities. This makes it challenging to fulfill the kidney healthcare needs of the most populous country of the world.³

Limited Renal Healthcare Infrastructure:

Infrastructure for providing comprehensive and integrated care to patients with kidney disease throughout the disease course, including kidney replacement therapy is lacking. There is tremendous geographic and urban–rural variation.⁴ An integrated end-stage kidney disease care entails utilization of all kidney replacement therapy modalities including comprehensive conservative care. Also, integrated care is necessary for multimorbid conditions and AKI prevention.

Affordability and Accessibility to Renal Medication:

Patients with and at risk of kidney disease in India face financial obstacles because of the high cost of treatment. Also, adherence to treatment is hampered by restricted access to essential medications.⁵ We need adequate availability of essential medicines to prevent the progression of CKD and the development of complications.

Underutilization of Preventive Measures:

Preventive measures and early detection are not given enough attention, even in this age of primordial prevention. Kidney health is not sufficiently integrated into current public health initiatives. Also, there is underutilization of nonpharmacological therapy, like physical exercise, dietary modifications, weight reduction, alcohol abstinence, and cessation of smoking by the primary healthcare providers and physicians.

Figure 1 depicts a strategic roadmap Affordability initiatives, Public awareness campaigns, Integration of public health programs, Capacity building, Empowering communities, Strengthening healthcare infrastructure (APICES) for advancing equitable access to care and optimal medication practise.

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Figure 1:

Kidney Health for All—Strategic roadmap for advancing equitable access to care and optimal medication practise.

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