Hyderabad: Surendra Kumar Sahoo was just 27 years old when he discovered that he was suffering from end-stage renal disease, which meant that his kidneys would no longer be able to function without medical support. After serious illness, he got his first kidney transplant in 1995, a left-side kidney donated by his mother. Thanks to the body’s immune system, the donated kidney could function for five years. This led to a second transplant at the age of 32, for the right kidney, donated by his elder brother. This time, the kidney lasted 11 years, before finally giving up and posing a great challenge for both the patient and the doctors. Despite that, Sahoo received the third transplant and is now a 60-year-old retired man, leading a normal life.
“It is one of the rare cases where a third transplant is successful,” said Dr Gandhe Sridhar, a senior consultant, nephrology and transplant physician, who successfully treated Sahoo. “After a transplant, the body’s immune system starts acting on it and tries to reject the kidney. We prevent this with immunosuppressants. The third transplant is very challenging as the body is already exposed to the immune system twice before. It isn’t easy to control the aggressive immune system with medications. In Surendra’s case, the third transplant worked well. He has now retired from NMDC and comes for consultation every week,” Dr Sridhar said.
Transplant becomes a reliable option for those grappling with Chronic Kidney Disease (CKD). This is because the other two options: hemo-dialysis and peritoneal dialysis do not promise a quality life and are able to compensate for only 50-60 per cent of an actual kidney’s functioning. It also leads to a larger cost of treatment.
“Transplant has given me a better life. I was able to work and be my family’s only bread-winner for the past 30 years,” said Surendra. “It takes a toll on your entire family and impacts everyone involved, mentally and physically,” he added.
Even after transplant, one has to observe some precautions, Sahoo mentioned, such as eating healthy, avoiding outside food and water, maintaining hygiene, and avoiding crowded places. While his company NMDC bore the cost of his treatment, he mentioned that a transplant costs around `6-8 lakhs in a private hospital. After transplant, about `13-14,000 are spent on medicines per month.
“Out of 100 patients suffering from CKD, only four are able to get a transplant,” Dr Sridhar stated. “This is due to difficulties in finding a blood-group matching donor, as mandated by the National Organ Donation Act,” he added.
While a 2014 amendment to the law allowed non-blood group matching transplants to be done after taking permission from the government, Telangana has yet not adopted it. “If allowed, we would be able to save around six months time that patients have to wait while the legal and administrative process goes on,” he said.
India sees approximately 800 CKD cases per 10 lakh people. In Hyderabad alone, around 8,800 individuals are affected by CKD and many of them will eventually require dialysis or kidney transplants. Hyderabad currently records around 1,200 kidney transplants annually, with this number expected to increase by 12 per cent to 16 per cent. By 2025, Hyderabad may need to perform 1,400 transplants to meet the growing demand for advanced kidney treatments.
“Advanced procedures such as ABO-incompatible and swap kidney transplants ensure that even patients without a blood-group-matching donor have a chance at a life-saving transplant and a better quality of life,” said Dr G.C. Malakondaiah, a consultant urologist.
These options have to be made permissible through legislative changes at both state and central level, the doctors mentioned.
More concerning is that CKD is closely linked to lifestyle-related diseases such as diabetes, hypertension, and obesity, which are becoming increasingly common in Hyderabad. These conditions gradually deteriorate kidney function, making regular check-ups and preventive healthcare essential.
“Kidney diseases often progress silently, with minimal or no symptoms in the early stages. Regular screenings for adults with risk factors like diabetes, hypertension, and obesity can help identify CKD in its early stages, reducing both mental stress and financial burden,” said Dr V S Reddy, Senior Consultant Nephrologist.
CKD can also be found in children, those with congenital abnormalities or genetic predisposition. Children born prematurely, those with repeated urinary tract infections, abnormal kidney scans, or a family history of kidney disease should undergo screening by paediatric nephrologists for early detection and treatment.
In recent years, self-medication, unprescribed polypharmacy, and unscientific diet protocols have also emerged as risk factors for kidney disease across all age groups.
