In a conversation with Arunima Rajan, Dr Nikhil Bhasin, Consultant Nephrologist and Renal Transplant Physician at Wockhardt Hospitals, highlights why kidney care must move from being a supporting service to a central pillar of hospital strategy in India.
Kidney Disease Surge Reshaping Hospital Planning
With an estimated 138 million Indians living with chronic kidney disease (CKD), hospitals are under increasing pressure to scale up infrastructure and services. This includes expanding dialysis capacity, creating dedicated nephrology units, and investing in advanced diagnostics for early detection.
Dialysis services, in particular, demand significant resources—ranging from specialised machines and water purification systems to trained technicians and nursing staff. As patient volumes grow, hospitals are also focusing on satellite dialysis centres closer to residential areas, reducing the burden of frequent travel for patients requiring multiple weekly sessions.
Dr Bhasin emphasises that kidney care can no longer be treated as a niche department. Instead, it must be deeply integrated into overall hospital planning, given the sustained rise in demand.
Tackling the “Silent Epidemic” Through Early Detection
Chronic kidney disease is often referred to as a silent epidemic, as symptoms typically appear only in advanced stages. Hospitals can play a crucial role in early detection by embedding kidney screening into routine care—especially for patients with diabetes, hypertension, cardiovascular disease, or obesity.
Simple blood and urine tests can help identify kidney damage early. Additionally, preventive health packages and awareness initiatives can encourage regular screening, particularly among high-risk populations.
Expanding Dialysis Sustainably
While dialysis is life-saving, it is also resource-intensive, requiring large volumes of purified water, electricity, and disposable consumables. As demand rises, hospitals are exploring sustainable solutions such as:
-
Recycling treated water for non-clinical use
-
Adopting energy-efficient dialysis systems
-
Reducing medical waste wherever feasible
Balancing clinical needs with environmental responsibility is becoming an important priority in dialysis programme expansion.
Home Dialysis: A Patient-Centric Alternative
Home-based dialysis is emerging as a viable solution for many patients. It reduces dependence on hospital visits and allows individuals to maintain a more normal lifestyle.
For hospitals, supporting home dialysis programmes can help ease capacity constraints in in-centre units. With proper training and monitoring, home dialysis can be safe, effective, and empowering for patients.
Addressing India’s Transplant Gap
Despite rising demand, kidney transplants in India are limited by a low rate of deceased organ donation. Lack of awareness and hesitation among families during critical moments remain key challenges.
Improving transplant rates will require:
-
Stronger public awareness campaigns
-
Better hospital coordination for donor identification
-
Transparent and efficient organ allocation systems
Integrating Kidney Care with Oncology
Advancements in cancer treatment have improved survival, but certain therapies—such as chemotherapy, targeted drugs, and immunotherapy—can impact kidney function.
Hospitals that integrate nephrology with oncology services can monitor kidney health proactively, manage complications early, and ensure patients complete cancer treatment safely.
Managing Acute Kidney Injury in Critical Care
Acute kidney injury (AKI) is a major concern in intensive care units, often triggered by infections, dehydration, shock, or medication side effects.
Improving outcomes depends on:
-
Early detection through continuous monitoring
-
Precise fluid and medication management
-
Multidisciplinary ICU teams for rapid intervention
Hospitals are increasingly adopting real-time monitoring systems to detect and address kidney complications promptly.
Building Future-Ready Kidney Care Programmes
According to Dr Bhasin, hospitals aiming to stay ahead must focus on three core pillars:
-
Early Detection – Expanding screening programmes to catch disease in initial stages
-
Technology Integration – Leveraging advanced dialysis systems and digital monitoring tools
-
Patient-Centric Care – Providing long-term support, education, and lifestyle guidance
As India’s kidney disease burden continues to grow, hospitals that align infrastructure, technology, and patient-focused strategies will be better equipped to deliver sustainable and effective care.