Telangana has recorded the highest mortality rate from chronic kidney disease (CKD) in India, according to a study published in the Indian Journal of Medical Research. The state reported 19.84 deaths per lakh population in 2023— nearly three times higher than Rajasthan, which recorded the lowest rate at 6.71 per lakh.
The study, based on data from the Global Burden of Disease 2023 database, noted that Telangana did not have the highest number of new CKD cases. Its incidence stood at 241.57 per lakh population, significantly lower than Haryana, which recorded the highest incidence at 316.35 per lakh.
Despite moderate case numbers, Telangana reported the highest disability-adjusted life years (DALY) at 666.38 per lakh, indicating a heavy combined burden of premature deaths and years lived with illness. Rajasthan, by comparison, recorded 312.21 DALYs per lakh.
“High-burden states such as Telangana and Punjab maintained CKD rates significantly above the national mean across all metrics,” the authors noted, pointing to persistent health system challenges.
The study highlighted disparities based on socio-demographic index (SDI), a composite indicator of income, education and fertility. Telangana falls in the mid-to-upper SDI range, yet its outcomes differ from similarly developed states.
“In high-SDI states, CKD is managed as a chronic long-term condition, whereas in low-SDI states, it disproportionately results in premature mortality and disability due to late diagnosis and limited treatment access,” the study observed.
The research, conducted by Hari Shankar Meshram of the Institute of Liver and Biliary Sciences along with Sanshriti Chauhan and Saurabh Puri, analysed trends across all states and Union Territories from 1990 to 2023.
Southern India showed marked contrasts. Kerala and Tamil Nadu recorded significantly lower mortality rates at 9.1 and 9.83 per lakh respectively—less than half of Telangana’s figure. Both states have also achieved faster declines in CKD mortality, at 1.6 per cent and 1.83 per cent annually since 1990, outperforming the national average decline of 0.9 per cent.
Andhra Pradesh reported 11.64 deaths per lakh, about 40 per cent lower than Telangana despite similar demographic and lifestyle risk factors. Karnataka recorded 13.34 deaths per lakh, above the national average but still below Telangana.
The study found that diabetes was a major contributor to CKD mortality in Telangana. Type-2 diabetes accounted for 25 per cent of CKD-related deaths in the state — the highest proportion in India — while Type-1 diabetes contributed to 6.6 per cent of new cases.
Mohammad Jahangir, Assistant Professor of Urology at Osmania Medical College, noted that kidney disease is often detected incidentally during treatment for other conditions.
“We usually detect it incidentally. If a patient comes with a urinary infection, we conduct tests and sometimes discover kidney damage,” he said, adding that routine screening is often skipped in younger patients due to the perception that CKD is rare in that age group.
The study also highlighted a broader national trend: hypertension-related CKD accounts for a disproportionately high share of deaths relative to its prevalence, indicating poor prognosis and delayed intervention.
A significant proportion of CKD cases across India remain classified as “other or unspecified,” accounting for over 66 per cent of incidence and nearly 68 per cent of prevalence. Researchers say this points to major diagnostic gaps across states.
The authors emphasised that CKD is currently not included in India’s National Programme for Prevention and Control of Non-Communicable Diseases, despite its growing burden.
“CKD must be urgently integrated into the national NCD strategy, with priority financing for dialysis and transplantation under Ayushman Bharat,” the study recommended.
It also called for state-specific surveillance systems, decentralised early detection programmes at the primary care level, and stronger focus on managing diabetes and hypertension.
“Without these measures, India risks a widening treatment gap that will disproportionately affect vulnerable populations,” the authors warned.
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