India faces massive silent health crisis:Study links rising diabetes cases to widespread kidney damage; warning of steep increase in deaths

India is facing a rapidly growing health crisis, with a new global study confirming that around 138 million Indians now live with chronic kidney disease (CKD) the second-highest number in the world after China. Kidney specialists say the scale of the problem has been visible in clinics for years, but largely hidden in the general population because most patients realise something is wrong only in the late stages of the disease. Doctors call this a silent epidemic, one that often shows no symptoms until kidneys are severely damaged. Most patients discover Kidney damage too late A significant concern is that many Indians feel healthy and do not undergo regular tests. By the time they seek medical help, symptoms such as swelling, breathlessness or severe fatigue have already appeared signs that kidney function has dropped sharply. But beneath this visible layer lies a much larger group, millions who feel well but already have protein leaking into their urine, a strong indicator of early kidney disease. This undetected group is what experts refer to as the “silent 138 million”. Diabetes and hypertension accelerating kidney decline India’s soaring diabetes numbers are at the centre of this health emergency. The country now has 101 million people living with diabetes and another 136 million in the pre-diabetic stage, placing them at high risk for kidney damage. Medical studies show that 20–30% of people with type 2 diabetes already have CKD, and doctors say it is common to diagnose diabetes and kidney disease together. In everyday clinical practice, one in five Indians shows some degree of kidney involvement at the time diabetes is first detected. Together, diabetes and high blood pressure account for the majority of kidney failure cases in India. Kidney disease deaths likely to rise over next 15 years Numbers alone are not the only worry the deaths linked to CKD are also climbing.
Between 1990 and 2021, global deaths and disability from chronic kidney disease due to diabetes increased sharply. Projections indicate that India may see a steep rise in CKD-related deaths in the next 10–15 years. Experts warn that without early detection and strict control of blood sugar, blood pressure and lifestyle risks, diabetic kidney disease could become as fatal as several major cancers. Yet, they stress that the tragedy is preventable. Treatment gap: only 10% receive dialysis or transplants When kidneys fail completely, patients need either dialysis or a kidney transplant. However, India adds 1.75 to 2.2 lakh new end-stage kidney disease patients every year, and only about 10% receive any form of renal replacement therapy. Organ shortage makes the situation even more difficult. India performs about 7,500 kidney transplants annually, whereas the actual need is nearly 30 times higher. T his means that nearly 90% of advanced CKD patients rely solely on dialysis, often facing repeated hospital visits, reduced income and a heavy financial burden. Doctors also emphasise that dialysis quality must improve, requiring trained staff, strict water standards and strong infection control practices. Early screening is the most urgent step Experts say the fastest way to slow this epidemic is to ensure routine kidney screening from the moment a person is diagnosed with diabetes.
Simple tests serum creatinine, eGFR and urine albumin, can detect damage years before symptoms appear. Health professionals urge patients to: Public health policy also needs to integrate CKD screening into national non-communicable disease programmes so that early detection services are available across clinics, community centres and primary health units. Human crisis behind the numbers The millions living with CKD are not just statistics. They are working parents, young adults trying to build careers, and grandparents hoping to see future generations grow. Without early testing and affordable treatment, many of them face lifelong dialysis, financial stress and loss of quality of life. According to Dr Asad Riyaz, Consultant, Nephrology and Kidney Transplant Surgeon at Kokilaben Dhirubhai Ambani Hospital, Indore, diabetes remains the biggest driver of this crisis.