A parliamentary committee has said that Chronic Kidney Disease has become one of the fastest-growing non-communicable diseases in the country, with a large number of patients diagnosed only after the disease has reached an advanced stage.

The Department-related Parliamentary Standing Committee on Health and Family Welfare, headed by Rajya Sabha member Ram Gopal Yadav, presented its report on the subject in the Rajya Sabha on Friday, August 7.

The 122-page report, based on months of hearings with the Ministry of Health and Family Welfare, the Ministry of Ayush and independent experts, sets out 63 recommendations covering prevention, screening, treatment and long-term care of kidney disease.

According to the report, India is estimated to have nearly 138 million people living with chronic kidney disease, the second largest such burden in the world.

It says close to 2.2 lakh new patients develop End Stage Kidney Disease every year, adding roughly 3.4 crore dialysis sessions to the system annually, on top of the sessions already required by existing patients.

“CKD has emerged as one of the fastest-growing non-communicable diseases in the country,” the committee noted, adding that the disease “has not yet received commensurate policy attention in proportion to its growing burden.”

The report acknowledges steps already taken by the government. It notes that the Pradhan Mantri National Dialysis Programme, launched in April 2016, now runs in 751 districts across 36 states and union territories, through 1,743 haemodialysis centres with 12,402 machines.

As of September 30, 2025, the programme has provided dialysis to 29.46 lakh patients over 375.88 lakh sessions. Dialysis is free for patients below the poverty line, while other patients pay the same rate the government pays on their behalf.

The report also refers to the “One Nation, One Dialysis” initiative, which allows patients to access dialysis services in any state through a common portal linked to their Ayushman Bharat Health Account.

Gaps in kidney care

Despite this, the committee found significant gaps.

It says rural populations, tribal communities and residents of remote areas continue to face limited access to nephrologists, diagnostic facilities, dialysis centres and transplant services.

“Financial hardship should not become a barrier to accessing life-saving kidney care,” the committee stated, while calling on the ministry to widen insurance coverage and expand affordable renal care in underserved regions.

The report also drew attention to a form of the disease not linked to diabetes or high blood pressure, called Chronic Kidney Disease of Unknown Etiology(CKDu), seen mostly among farm workers exposed to heat, pesticides and unsafe drinking water.

The committee has asked the ministry, along with the Indian Council of Medical Research and other departments, to conduct focused research and establish surveillance in affected areas. It has also linked the issue to climate change, recommending that ministries responsible for the environment, labour, agriculture, and water resources work together on heat mitigation and access to safe water for at-risk workers.

The disease often shows no symptoms in its early stages, the report said, so many patients are only detected after substantial kidney damage has already occurred. The committee has asked for stronger screening and referral systems within primary healthcare, along with wider awareness campaigns aimed at both the public and healthcare workers.

Among its other recommendations, the committee has proposed setting up a National Kidney Registry and a National CKD Performance Dashboard to track patients and outcomes across the country.

It has also recommended a Workplace Kidney Health Programme, greater focus on paediatric kidney care, tighter regulation of kidney-related medicines and devices, and support for domestic manufacturing of dialysis equipment and consumables.

The report says the government should shift its approach from mainly treating the disease to preventing it. It recommends that Ayushman Arogya Mandirs, the country’s primary health centres, take on a bigger role in spreading awareness, encouraging lifestyle changes and identifying high-risk individuals early, so that fewer patients eventually need dialysis or a transplant.

The committee has asked the Ministry of Health and Family Welfare to treat kidney disease as a national priority and to draw up a coordinated strategy with clear targets, saying this is needed to address the “systemic gaps” it identified during its examination.

Nephrologist on key risks

Dr Tarun Yadav, consultant nephrologist and transplant physician at Ujala Cygnus Superspeciality Hospital, said diabetes and hypertension remain the leading causes behind the rise in CKD cases in the country.

“Indians have started having a similar lifestyle to that of the United States, with an increase in the consumption of fast foods, so their metabolism has become similar to that of the US,” he observed.

Dr Yadav, who practices in Rewari, Haryana, said a major reason patients reach nephrologists too late is that they first consult general physicians, who do not always identify kidney-specific symptoms.

“By the time the patient comes to a nephrologist, there is not much left to do,” he said, adding that many patients also turn to homoeopathic and ayurvedic treatments before seeking specialist care. Treatments, he said, are not tightly regulated by the Drugs Controller General of India, the body responsible for drug regulation in the country.

He said unsupervised use of painkillers is another major contributor to kidney damage.

“One often goes to the pharmacy and takes painkillers or anti-inflammatory drugs. If it is taken for more than two days, then it can be really harmful for the body,” he mentioned.

He recalled treating two patients whose kidney problems began after they picked up painkillers from local chemists without a prescription. He also pointed to excess electrolyte intake and certain hair dyes as lesser-known risks to kidney health, and said high-end antibiotics prescribed by local doctors in rural areas are contributing to rising bacterial resistance.

On the parliamentary report’s finding that CKD is often diagnosed only after major damage has occurred, Dr Yadav said basic screening tests are inexpensive and widely available.

“It hardly takes 200 rupees to get these tests done, which is widely available and can be tested in a simple laboratory,” he said, referring to urine tests, serum creatinine and eGFR, a blood test that measures how well the kidneys are filtering waste from the body. He said people should get tested more regularly than they currently do.

Responding to the report’s findings on CKD of Unknown Etiology, largely seen among farm workers, Dr Yadav said this form of the disease is more common among farmers in tribal and rural regions, including in states like Andhra Pradesh.

“This occurs more among farmers from tribal and rural areas because they are heavily under the sun, which leads to dehydration as they do not consume enough water,” he said, adding that frequent consumption of sugarcane juice and other high fructose drinks adds to the risk.

Unlike the report, which flagged access gaps in dialysis and transplant services, Dr Yadav said treatment availability is no longer the main barrier in states like Haryana, Delhi and Rajasthan, where he has practised.

“Nobody is dying due to unavailability of dialysis and treatment,” he said, noting that district hospitals now offer facilities that make care more accessible for patients from rural areas.

He said financial and logistical strain on families remains a bigger challenge, since dialysis patients need someone to accompany them for regular sessions.

“CKD is not a disease of a patient, but that of a family,” he said.

On the report’s recommendation for a National Kidney Registry, Dr Yadav agreed it was needed, noting that India currently does not maintain a registry for any disease.

“It would help us plan better for the prevention and cure of the diseases,” he said. He also called for greater awareness around organ donation and living donor transplants, which he said offer easier long-term follow-up compared to dialysis.

He said school-level awareness programmes on kidney health remain lacking in India, and suggested social media could help reach more people if used effectively, an effort he has begun himself through an awareness page. He also mentioned that many patients still turn to a nephrologist only after alternative treatments fail.

“They often require admission in the ICU and die in two to three months from the time they visited the doctor for treatment,” Dr Yadav pointed out.

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