Kidney Diseases

Kidney diseases include acute and chronic conditions affecting kidney structure and function. In India, diabetes and high BP cause most chronic disease; infections, stones, obstruction, and drug-induced injury account for much of the acute burden; and CKD of unknown cause (CKDu) is a growing problem in certain regions.

Main categories

• Chronic kidney disease (CKD) — see separate page.
• Acute kidney injury (AKI) — see Kidney Failure.
• Glomerulonephritis (GN) — immune-mediated inflammation (IgA nephropathy, membranous, lupus nephritis, post-infectious GN).
• Polycystic kidney disease — genetic; multiple cysts, progressive.
• Kidney stones — see separate page.
• Urinary tract infections and pyelonephritis — see Urinary Tract Infections.
• Kidney cancer — see Kidney Cancer.
• Congenital kidney problems in children.
• CKDu (CKD of unknown cause) — parts of Andhra, Odisha, Chhattisgarh, Maharashtra — thought to involve agrochemical and heat-related factors.

Warning signs

• Swelling of feet, ankles, face (especially mornings).
• Frothy urine, blood in urine.
• Persistent high BP, especially young-onset.
• Fatigue, poor appetite, itching, cramps, restless legs.
• Unexplained anaemia.
• Back/flank pain + fever + urinary symptoms.

Screening every year if

• Diabetes, high BP, heart disease, family history of kidney disease, age ≥ 60.
• Living in a CKDu-endemic district.
• Past AKI, recurrent stones, repeated UTIs.

Avoid

• Long-term NSAID use without medical review.
• Unregulated Ayurvedic, Unani, or herbal products — repeated reports of heavy-metal and nephrotoxic-plant contamination causing rapid-onset CKD.
• IV contrast scans in dehydrated patients without hydration.
• Self-medicating with antibiotics — aminoglycosides and some combinations are nephrotoxic.