In a country where doctor-to-patient ration is 1:1700, the abysmal dip on the nephrology front is further depressing. There are only 1,100 nephrologists for a population of 120 crore people.
Of this huge population nearly 3% develops Chronic Kidney Disease (CKD) in their lifetime, with over 90% dying annually according to a recent All India Institute of Medical Sciences (AIIMS) study. Only 10% of Stage 5 CKD patients receive either dialysis (80% of this 10%) or transplant according to Dr SK Agarwal at AIIMS.
Two reasons for the low capacity to deal with CKD in a country as vast as India, are lack of healthcare resources and affordability. The situation is hard in rural areas as most of these specialists are based in urban areas; possibly due to access to specialty hospitals where they could work or better infrastructure available.
Nephrologists, who assemble in conferences and CMEs, are also worried by this skewed ratio, but can do little about it. Medical colleges offering postgraduate specialization in nephrology are few due to lack of faculty, over and above of an already small funnel of medical colleges created and maintained in India.
This makes the role of the nephrologist even more important, and the need to train General Practitioners on the basics of diagnosis and referral of kidney care patients even more important. This should be a major goal of World Kidney Day, over and above creating better capacity for delivery of related services. A vital shot in the arm to kidney care has been provided by Union Budget 2016, identifying public private partnership (PPP) provision of healthcare services, as a major thrust area for healthcare delivery.