Renal Disease Prevention and Management: A Physician's Perspective

Approximately two thirds of patients of chronic kidney disease, hypertension and diabetes mellitus are the underlying causes. The main reasons underlying this transition have been marked changes in our lifestyle. Although the exact data is not known, few epidemiological studies have suggested a huge burden of disease due to chronic kidney disease. For a nation of over one billion people, there are fewer than 1000 trained nephrologists in India. Hence, the onus for treating majority of these patients rests on general physicians and internists. Therefore, it is imperative that general physicians are well versed with the basic knowledge and current clinical practice guidelines for the management of various renal diseases. They have a unique advantage of reaching out to large number of persons who have renal diseases or are at risk of developing renal disease, and can also advise about various primary and secondary preventive strategies. Appropriate management of end stage kidney failure entails massive financial burden on the individual, family, overcrowded tertiary care hospitals and the whole country. In addition, lack of adequate facilities for dialysis and transplantation further compounds the problem. Despite various efforts, cadaveric renal transplant programme is still in infancy in India. Due to lack of adequate funding by the government and insurance agencies and low per capita income, less than 10 percent of the patients with end stage renal disease are able to avail definitive form of renal replacement therapy. In a country, where prevention and treatment of various infectious diseases such as malaria, tuberculosis, dengue fever, etc. take priority, not enough funds are left for management of various non-communicable diseases especially chronic kidney diseases. Hence various preventive strategies remain the only option for decreasing the burden of disease due to chronic kidney disease. This book is a humble attempt to fill the lacuna due to non-availability of any book on renal medicine by various Indian authors. Besides internists and general physicians, the book also tends to meet the aspirations of undergraduate and postgraduate students of medicine and young nephrologists.