Chronic kidney disease (CKD) is emerging as a major public health concern in India, with research showing a steady rise in its prevalence over the past decade. A review published in the journal Kidney International Reports estimates that nearly 13% of the Indian population may be affected by CKD, placing a significant burden on the country’s healthcare system and highlighting the urgent need for awareness, early detection and preventive care.
While diabetes and hypertension remain the most widely recognised causes of kidney disease, growing evidence suggests that environmental and occupational factors such as extreme heat exposure, dehydration and pollution may also be contributing to the rising numbers.
A cross-sectional study conducted among 1,136 participants in the Bargarh district of Odisha examined the impact of heat stress on kidney health, particularly among farmers. The study identified 157 potential cases of heat stress nephropathy, with more than 63% of affected individuals involved in farming activities. Researchers found significantly elevated markers of dehydration and kidney stress, including high urine specific gravity, increased blood urea nitrogen levels and raised heat shock proteins - biomarkers associated with cellular stress caused by extreme heat exposure.
The findings suggest that prolonged exposure to high temperatures, combined with strenuous labour and inadequate hydration, may significantly increase the risk of kidney injury over time. Similar concerns have been observed in other high-temperature work environments across India.
This World Kidney Day, we spoke to Dr Mathew Gerry George, Senior Consultant in Nephrology at SRM Global Hospital, to understand how heat, dehydration, pollution and lifestyle factors are affecting kidney health, and what people can do to protect themselves from the growing risk of chronic kidney disease.
Climate change and kidney health
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Dr Mathew explained that the effects of climate change are increasingly being felt beyond the environment and are beginning to affect human health in unexpected ways.
“Increasing heat waves, water scarcity, and pollution may be contributing to rising risks of kidney disease, particularly among vulnerable people,” he said.
What is heat-stress nephropathy?
One condition that has drawn increasing attention is heat-stress nephropathy, a form of kidney damage associated with repeated dehydration and prolonged exposure to high temperatures.
“In simple terms, repeated dehydration caused by extreme heat can slowly injure the kidneys,” Dr George said. When the body loses large amounts of fluid, blood flow to the kidneys decreases, forcing them to work harder to filter toxins under stress. Over time, repeated episodes of dehydration can lead to permanent kidney damage.
He noted that the condition is most commonly observed among outdoor workers in tropical regions, particularly those who spend long hours in high temperatures. “Farmers, construction labourers and other outdoor workers are especially vulnerable because they often work for extended periods in the sun,” he added.
Environmental exposure and kidney damage
India already carries a significant burden of kidney disease, and emerging evidence suggests that environmental factors may be playing a larger role than previously understood. Studies conducted among agricultural communities have found that around 5.31% of farmers showed signs of chronic kidney damage, with nearly half of these cases occurring without the traditional risk factors of diabetes or hypertension.
“This indicates that environmental stressors, including heat exposure and occupational conditions, may be contributing to kidney injury,” Dr George explained.
Heat is not the only concern. Research from different parts of India has also detected higher levels of heavy metals such as cadmium, arsenic, lead and chromium among individuals suffering from chronic kidney disease. According to Dr George, these toxic substances can enter the body through contaminated drinking water, pesticide exposure or industrial pollution.
“Over time, these toxins can damage the kidney’s filtration system and contribute to chronic kidney disease,” he said.
How can you protect your kidneys in a warming climate?
Dr George emphasised that protecting kidney health in a warming climate begins with simple but consistent preventive habits. “Hydration is the most important step,” he said.
According to Dr George, drinking water regularly throughout the day helps maintain blood flow to the kidneys and reduces the strain placed on the organ during extreme heat. People working in high temperatures should make a conscious effort to stay hydrated and avoid long periods without fluid intake.
He also pointed out that small behavioural changes during hot weather can significantly reduce the risk of dehydration and kidney stress. “Taking breaks in shaded or cooler areas and avoiding peak afternoon heat whenever possible can help the body recover from prolonged heat exposure,” he explained. Such precautions are especially important for outdoor workers such as farmers, construction labourers and others who spend long hours in the sun.
Lifestyle choices also play an important role in protecting kidney function. Dr George advised moderating salt intake and being cautious about the unnecessary use of painkillers, which can place additional strain on the kidneys when used frequently. “Many people overlook how everyday habits can affect kidney health. Simple steps taken consistently can go a long way in preventing long-term kidney damage,” he added.
Recognising early warning signs
Another challenge, Dr George noted, is that kidney disease often develops silently, with symptoms appearing only after significant damage has occurred.
“Many kidney diseases progress quietly. People should seek medical advice if they notice swelling in the legs or face, unexplained fatigue, changes in urination, or persistent high blood pressure,” he said.
Early detection and timely treatment, he adds, can significantly reduce the risk of severe kidney complications.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS