Perspectives on Kidney Care in India: Curated by the ISN Young Nephrologists Committee
Ahead of the 2025 World Congress of Nephrology (WCN’25) in New Delhi, the ISN Young Nephrologists Committee invited ISN members from India to share their perspectives on the current state and future of kidney care in this vast and diverse country. They highlight the unique challenges, innovative solutions, and growth opportunities that define nephrology in India today.
Accessibility to kidney care
“Equitable access to dialysis remains a challenge in India, especially in rural areas where patients often travel hours for treatment. To address this, a national strategy should prioritize innovative, cost-effective solutions like mobile and home-based dialysis technologies. The Pradhan Mantri National Dialysis Program (PMNDP) is a promising start, providing free dialysis services to underserved populations. Public-private collaborations can further enhance sustainability and extend access to all, irrespective of geography or socioeconomic status.” Sourabh Sharma
“We need to train non-physician healthcare workers to perform basic nephrology tasks under supervision, bridging the urban-rural divide and expanding care access in remote areas. Infrastructure for dialysis and transplantation to improve access, affordability, and quality is also necessary, as are government-funded programs to subsidize care and promote organ donation for patients with kidney failure.” Mythri Shankar
“Expanding nephrology care must be equitable and sustainable. Quality education in nephrology should remain a priority, with transparent and accountable processes to foster trust and excellence in training future nephrologists.” Vivek Kumar
“Programs like the Pradhan Mantri National Dialysis Programme have improved access by providing free dialysis to underserved populations. However, further efforts are needed to expand dialysis and transplant services in rural and underserved areas to reduce disparities.” Shyam B. Bansal
Prevention and early detection
“India faces a growing burden of CKD driven by metabolic syndrome, diabetes, and hypertension. Prevention must become a national priority, emphasizing early screening, public education, and lifestyle interventions. Robust public health programs focusing on primordial and primary prevention strategies will be vital to curbing CKD and improving kidney health outcomes.” Dr. Sharma
“Early detection and prevention of kidney diseases must be prioritized, with a focus on addressing preventable causes of acute kidney injury such as tropical illnesses, obstetric complications, snake bites, and toxins through locally tailored solutions. Training non-nephrology healthcare providers in the early recognition and management of kidney diseases can enhance preventive care. Additionally, tele-nephrology holds promise in bridging urban-rural gaps by providing specialized care to remote areas.” Divya Bajpai
“Early identification and intervention in India can be improved by promoting kidney health awareness through public campaigns, school curricula, and healthcare provider training. In addition, widespread screening programs should be implemented, focusing on risk factors like diabetes, hypertension, and environmental or genetic contributors.” Dr. Shankar
“Preventive strategies are crucial to reducing the CKD burden. Public education campaigns focus on raising awareness of risk factors like diabetes and hypertension. The Indian Society of Nephrology’s targeted CKD screening programs aim to detect and intervene early in high-risk populations.” Dr. Bansal
“Beyond treatment, prioritizing prevention is crucial. Local context research should address India’s unique challenges, while advocacy efforts must push for kidney health policies at the highest levels of governance. Effective prevention strategies will reduce disease burden and improve outcomes.” Dr. Kumar
Advocacy and policy reform
“Gender disparities in kidney replacement therapy persist, with women in South Asia significantly less likely to receive dialysis or transplants. Addressing these inequities requires raising awareness and tackling systemic barriers, including societal norms and healthcare policies. Advocacy for gender equality in kidney care can ensure timely diagnosis, effective management, and equitable access to treatment for women. Dr. Sharma
“Support local nephrology research to develop data-driven solutions tailored to India’s challenges. Advocate for policy reforms to integrate kidney care into broader non-communicable disease (NCD) management strategies. Dr. Bansal
“Advocacy efforts must push for kidney health policies at the highest levels of governance.” Dr. Kumar
“Policy reforms are essential to ensure affordable medications, equitable access to dialysis, and increased research funding. Advocacy must elevate kidney health as a priority in India’s healthcare agenda.” Priti Meena
Building the workforce
“Building a robust nephrology workforce requires attracting young talent. Integrating nephrology exposure into undergraduate medical education is crucial to spark early interest. Mentorship programs, research platforms, and increased funding opportunities can inspire early-career physicians to pursue academic nephrology, fostering a motivated pipeline of professionals to advance kidney care and research in India.” Dr. Bajpai
“If we train non-physician healthcare workers to perform basic nephrology tasks under supervision, we can help bridge the urban-rural divide and expand care access in remote areas.” Dr. Shankar
“India’s nephrology training programs produce over 400 nephrologists annually, with over 3,000 in practice. Specialized fellowships in interventional nephrology, critical care, and transplantation, supported by partnerships with the International Society of Nephrology, are enhancing the skills of young nephrologists.” Dr. Bansal
“Inspiring the next generation of physicians and researchers to choose nephrology is critical, as is expanding the nephrology ecosystem to include allied health professionals — emphasizing the need for a team-based approach to kidney care.” Dr. Kumar
“We must reframe nephrology as a dynamic, life-saving specialty with vast opportunities for growth and impact rather than a complex or niche field. We must inspire new entrants to excel in areas like clinical care, translational research, and sustainable practices. These efforts will not only align Indian nephrology with global standards but position it as a model of resilience and innovation for other developing nations.” Dr. Meena
Sustainability and innovation
“Sustainability in kidney care is vital. Dialysis, in particular, consumes significant resources and generates medical waste, contributing to healthcare’s carbon footprint. Innovative solutions, such as integrating solar panels, regenerating RO water, encouraging local production of PD fluids, and improving waste management, are essential. Adopting lean kidney care practices can reduce costs and emissions, creating an eco-friendly nephrology ecosystem aligned with global climate goals.” Dr. Bajpai
“Integrate telemedicine, AI, and remote monitoring to enhance diagnostics, personalize treatment, and improve chronic kidney disease management. Establish a national electronic health record system to standardize data collection and clinical practices.” Dr. Shankar
“Indian nephrologists are contributing to global research in CKD prevalence, cost-effective therapies, and regional challenges. Collaborative research with international societies is vital for developing innovative solutions and addressing global kidney health needs.” Dr. Bansal
“Bridging clinical practice and research is vital. Embedding research into routine care will generate evidence-based solutions tailored to local needs, improving patient outcomes and advancing nephrology as a discipline.” Dr. Kumar
“India’s unique demographics demand innovative, tailored solutions. By leveraging available resources, we can improve outcomes through advances in peritoneal dialysis, interventional nephrology, waste management, glomerular disease research, and early CKD detection.” Dr. Meena
Indian nephrologists eagerly anticipate WCN’25 as a landmark event for showcasing local innovations and addressing global kidney health challenges. The congress is expected to provide opportunities for exposure, collaboration, and learning that will enhance clinical care and research – see you at WCN’25!