Managing Chronic Kidney Disease (CKD) in India: From Dialysis to Pre-Transplant Care

18 July,2025

Chronic Kidney Disease (CKD) in India is often called a silent threat, progressing slowly and quietly until it demands urgent medical intervention. For thousands of individuals in India, the journey with CKD begins not in a hospital, but with subtle signs easily missed: persistent fatigue, swelling in the legs, or uncontrolled blood pressure. By the time these symptoms are recognized, many are already facing decisions about dialysis or transplantation.

Across India, families navigate a complex landscape of medical options, financial hurdles, and emotional strain. While access to care has improved significantly through government programs and policy reforms, the experience of living with CKD still varies greatly between urban and rural regions. From state-run dialysis units to home-based peritoneal care and transplant referrals, the Indian healthcare system is getting better.

This blog explores how India is responding to CKD through early diagnosis, expanding dialysis access, and streamlining pre-transplant care.

Looking for the best doctor ?

Fill up the form and get assured assitance within 24 hrs!

Name *

Email *

Select Your Country

Phone Code

Mobile Number *

Is the above number on WhatsApp? *

Yes

No

Phone Code

Whatsapp Number *

Query

The Growing Burden

Research suggests that almost 10% of the world population suffers from some level of kidney dysfunction. Contributing factors include hypertension, diabetes, and use of over-the-counter medicines, which are known risk drivers of kidney damage.

Speak with a Medical Coordinator

Get help choosing the best doctor and hospital for your care.

Send Enquiry WhatsApp Us

Success Stories and Positive Developments

Despite the challenges, India has witnessed remarkable success stories that inspire hope. The launch of the Pradhan Mantri National Dialysis Programme (PMNDP) has revolutionized access to dialysis care, particularly for economically disadvantaged populations. Under this program, over 3,000 dialysis centers have been established nationwide, offering free dialysis sessions to eligible patients.

Several states have emerged as models of excellence in CKD management. Tamil Nadu's comprehensive kidney care program has achieved a 40% reduction in CKD-related mortality over the past five years. Similarly, Kerala's community-based screening initiatives have successfully identified early-stage CKD in over 200,000 individuals, allowing for timely intervention and lifestyle modifications.

The integration of technology has also brought positive changes. Telemedicine platforms now connect rural patients with specialist nephrologists in urban centers, breaking down geographical barriers. Mobile health applications help patients track their medication schedules, dietary intake, and vital parameters, empowering them to take an active role in their health journey.

Financial Support and Accessibility

Dialysis treatment in India is becoming increasingly affordable and accessible. Public hospital sessions typically cost around INR 2,500, while private clinics may charge more than INR 5,000 per session. However, government initiatives have made significant strides in reducing this financial burden.

For example, the Delhi government recently deployed an additional 150 dialysis machines across six public hospitals to expand the reach of care. The Central Government Health Scheme (CGHS) and various state health insurance programs now cover the cost of dialysis, making treatment accessible to millions of beneficiaries.

Speak with a Medical Coordinator

Get help choosing the best doctor and hospital for your care.

Send Enquiry WhatsApp Us

Innovative Treatment Approaches

India's healthcare system has embraced innovative approaches to CKD management. The development of indigenous dialysis machines has reduced treatment costs by 30% while maintaining international quality standards. Indian manufacturers, such as Nephroplus and Fresenius Kabi, have established world-class production facilities, making India a hub for affordable dialysis equipment.

Home-based peritoneal dialysis programs have shown exceptional results, with patient satisfaction rates exceeding 85%. These programs not only reduce healthcare costs but also allow patients to maintain their daily routines and family relationships while receiving treatment.

Diagnosis and Treatment Guidelines

Early diagnosis is still the most powerful intervention. The ICMR and Ministry of Health issued Standard Treatment Workflows recommending eGFR, serum creatinine, blood pressure checks, urinalysis, and avoidance of nephrotoxic drugs in primary care.

Nutritional guidelines include a lower protein intake (0.6–0.8 g/kg/day), a low-sodium salt diet (<5 g/day), and restriction on potassium-rich foods in advanced disease.

Once patients reach an of less than 30 mL/min, referrals to a nephrologist become critical. In district hospitals, the creation of vascular access (AV fistula or PDa) is a standard procedure. Tertiary centres offer kidney biopsies, imaging, psychological assessments, and discussions on renal replacement therapy (RRT) options.

The graph below outlines how CKD treatment evolves across different stages, offering a clear view of when lifestyle changes, medications, dialysis, or transplant become necessary.

Speak with a Medical Coordinator

Get help choosing the best doctor and hospital for your care.

Send Enquiry WhatsApp Us

Dialysis Modalities and Their Challenge

Most ESRD patients (around 94%) undergo haemodialysis, which requires professional staff and machine-intensive setups. While efficient, HD is costly and often concentrated in urban centres, leaving rural populations underserved.

To address this, the government has been promoting peritoneal dialysis (PD)—a home-based alternative that requires less infrastructure and is better suited for remote locations. By the end of 2022, several states had initiated PD programs, exhibiting promising signs of success and cost savings.

Pre-Transplant Pathways

Transplant referral is usually suggested once eGFR dips below 30 or symptoms worsen. Pre-transplant setup involves preserving veins for access (usually in the non-dominant arm), conducting a comprehensive workup (including lab tests and imaging), counseling patients and their families, and adhering to legal frameworks outlined in the Transplantation of Human Organs and Tissues Act (1994, amended 2011).

Most transplants still rely on living donors. Equally, financial aid often overlooks long-term postoperative care, meaning patients may struggle to afford ongoing immunosuppressants.

Speak with a Medical Coordinator

Get help choosing the best doctor and hospital for your care.

Send Enquiry WhatsApp Us

Community Support and Patient Empowerment

The emergence of patient support groups and non-governmental organizations has created a strong network of hope and resilience. Organizations like the Kidney Warrior Foundation and Amar Gandhi Foundation provide emotional support, financial assistance, and advocacy for CKD patients and their families.

Community-based rehabilitation programs have helped thousands of patients return to productive lives post-treatment. These programs focus on vocational training, psychological counseling, and peer support, ensuring patients with CKD can maintain their dignity and independence.

What Could Change the Game?

CKD management in India can be transformed through:

• Wider access to dialysis through mobile units or rural satellite centres, supported by PMNDP
• More home-PD programs with local training and nurse supervision
• Lower-cost transplant aftercare, mainly covering lifelong medications
• Uniform transplant rules, with single-window approvals
• Public awareness campaigns via primary care and digital channels
• Community-based screening programs to detect CKD early among at-risk groups

Speak with a Medical Coordinator

Get help choosing the best doctor and hospital for your care.

Send Enquiry WhatsApp Us

Takeaway

Nephrology care in India requires a connected effort, from early screening and community awareness to home-based dialysis and fair transplant access.

By blending government schemes, digital tools, clinical best practices, and patient-centered care, India could make a meaningful difference in the lives of millions living with CKD.

The future of CKD management in India looks promising, with continued investment in healthcare infrastructure, technological innovations, and patient-centric care models. With collective effort and sustained commitment, India can transform the approach of kidney care, providing hope to millions of patients and their families worldwide.

FAQs About Chronic Kidney Disease (CKD) in India

Q1. Can I live a normal life with chronic kidney disease (CKD)? 

Answer: Yes, many people with CKD live full and active lives. While the kidneys may not recover from existing damage, the condition doesn't always worsen. Only a small number of people reach advanced stages of the disease. With regular checkups, healthy habits, and the proper treatment, CKD can be managed for years without significant issues.

Q2. How is CKD usually managed? 

Answer: Managing CKD means taking care of your overall health. This includes maintaining blood pressure and blood sugar levels within a healthy range, taking prescribed medications on time, working closely with your healthcare team, eating a balanced diet, staying physically active, keeping a healthy weight, and getting sufficient sleep.

Q3. What are the key lifestyle tips for people with CKD? 

Answer: Some small but meaningful changes can help. Quitting smoking, eating a balanced diet, reducing salt intake to less than 6 grams a day (approximately one teaspoon), and staying physically active for at least 150 minutes a week are all recommended. These changes support your kidney health and overall well-being.

Q4. What are the four main treatments used for CKD today? 

Answer: Doctors often use four treatment types to help protect the kidneys:

• RAS inhibitors
• SGLT2 inhibitors
• GLP-1 receptor agonists
• Non-steroidal mineralocorticoid receptor antagonists (nsMRAs)

These help slow down kidney damage, especially in people with diabetes-related kidney issues.