Marking a policy shift from focusing on treating advanced kidney failure cases to preventing disease progression, a parliamentary committee has proposed mandatory kidney function tests every six months for everyone aged 20 years and above.
This was recommended to be done along with annual screening of all high-risk individuals, with the biannual kidney function test (KFT) be provided free of cost to people below the poverty line and at a nominal cost to those above the poverty line under the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD).
What are the non-negotiables for high-risk individuals?
The screening should include assessment of kidney function using estimated glomerular filtration rate (eGFR) and urine albumin/protein testing, along with appropriate referral and follow-up.
"The committee, therefore, recommends that the ministry institutionalise regular annual CKD screening of all high-risk individuals and mandatory biannual kidney function test (KFT) of all persons aged 20 years and above, free of cost for persons Below Poverty Line (BPL) and on nominal cost for Above Poverty Line (APL) persons under the NP-NCD to enable early diagnosis and delay disease progression," the report said.
The panel observed that the principal high-risk groups requiring periodic screening included people with diabetes and hypertension, which together account for the majority of chronic kidney disease (CKD) cases in the country.
Who all come under the priority groups?
Adults above 60 years, people with a family history of kidney disease, obesity or tobacco use, and those with a history of acute kidney injury, recurrent urinary tract infections, recurrent kidney stones or prolonged exposure to nephrotoxic medicines, including non-steroidal anti-inflammatory drugs (NSAIDs).
A key recommendation made by the panel is that every serum creatinine test conducted in public and private diagnostic laboratories should automatically include an eGFR report, preferably calculated using the CKD-EPI equation, without a separate test request or additional cost to the patient.
The report also noted that nearly 2.2 lakh new patients with end-stage kidney disease are added every year, creating an additional demand of about 3.4 crore dialysis sessions annually.
(With PTI inputs)
