Prevention is the only key to keeping your kidneys healthy Dr. Shoeb Khan Leading Nephrologist

Chronic kidney disease (CKD) affects approximately 850 million people globally and is a leading cause of death and disability. In India, an estimated 17% of the population has some degree of CKD — yet most people are unaware of their kidney health until significant damage has already occurred. We spoke with Dr. Shoeb Khan, a leading nephrologist, about why prevention is the cornerstone of kidney health.

Why Is Kidney Disease So Often Diagnosed Late?

"The kidneys are remarkably resilient organs," Dr. Khan explains. "They can lose up to 60–70% of their function before symptoms appear. By the time most patients come to me with symptoms — fatigue, swelling, reduced urine output — significant and often irreversible damage has already occurred. This is why early detection through regular screening is so critical."

He emphasizes that the most common causes of CKD in India — diabetes and hypertension — are themselves often undiagnosed or poorly controlled. "If we can control diabetes and hypertension effectively, we can prevent the majority of CKD cases. But that requires early diagnosis and sustained management of these conditions."

Who Is at Risk for Kidney Disease?

"The highest-risk groups are people with diabetes, hypertension, a family history of kidney disease, obesity, and those over 60," Dr. Khan says. "In India, we also see significant CKD burden from recurrent kidney stones, chronic use of NSAIDs and traditional herbal medicines, and endemic nephropathy in agricultural communities."

He highlights the genetic component. "Kidney disease runs in families. Conditions like polycystic kidney disease (PKD), Alport syndrome, and focal segmental glomerulosclerosis (FSGS) are directly caused by genetic mutations. But even common CKD from diabetes and hypertension has significant genetic susceptibility components — some people's kidneys are more vulnerable to damage from these conditions than others."

The Genetics of Kidney Disease

Several genetic conditions directly cause kidney disease:

• Autosomal Dominant Polycystic Kidney Disease (ADPKD): Caused by mutations in PKD1 or PKD2. The most common inherited kidney disease, affecting 1 in 400–1,000 people. Causes progressive cyst formation leading to kidney failure, typically in the 4th–6th decade.
• Alport Syndrome: Caused by mutations in COL4A3, COL4A4, or COL4A5 (collagen genes). Causes progressive kidney disease, hearing loss, and eye abnormalities.
• APOL1 variants: Common in people of African ancestry. Significantly increases risk of kidney disease from hypertension and HIV.

Prevention: Dr. Khan's Key Recommendations

• Control blood sugar: HbA1c below 7% dramatically reduces diabetic kidney disease risk
• Control blood pressure: Target below 130/80 mmHg; ACE inhibitors and ARBs are kidney-protective in diabetic and hypertensive kidney disease
• Stay hydrated: Adequate water intake reduces kidney stone risk and supports kidney function
• Avoid nephrotoxic medications: NSAIDs (ibuprofen, diclofenac), contrast dyes, and certain herbal medicines can damage kidneys — use with caution
• Don't smoke: Smoking accelerates kidney disease progression
• Get regular kidney function tests: Annual creatinine, eGFR, and urine albumin-to-creatinine ratio for high-risk individuals

FAQs

How often should I get my kidneys checked?

Annual kidney function testing (creatinine, eGFR, urine albumin) is recommended for people with diabetes, hypertension, obesity, family history of kidney disease, or age over 60. For the general population, testing every 2–3 years is reasonable.

Can kidney disease be reversed?

Early-stage CKD can sometimes be stabilized or slowed with aggressive risk factor management. Advanced CKD is generally not reversible, but progression can be significantly slowed. This is why early detection is so critical.