A parliamentary committee has called for a major shift in how chronic kidney disease is detected and managed in India, recommending mandatory kidney function testing every six months for everyone aged 20 and above.
The recommendation aims to move the country away from a healthcare approach that often begins only after kidney disease has become serious, and towards prevention, early diagnosis and timely treatment.
The Parliamentary Standing Committee on Health and Family Welfare has recommended that biannual kidney function tests be made free for people below the poverty line and available at a nominal cost for those above the poverty line under the National Programme for Prevention and Control of Non-Communicable Diseases.
For people considered at high risk of kidney disease, the committee has recommended annual screening that includes estimated glomerular filtration rate, known as eGFR, along with urine albumin or protein testing, appropriate referrals and continued follow-up.
The recommendations were included in the committee’s 177th report on “Prevalence of Chronic Kidney Disease in India – Prevention, Diagnosis, Treatment and Management”. The report contains 66 recommendations covering prevention, early detection, diagnosis, treatment and long-term management of chronic kidney disease.
The report was presented in the Rajya Sabha and laid on the table of the Lok Sabha on August 7.
Why The Committee Wants Kidney Testing To Start At 20
One of the biggest concerns highlighted by the committee is that chronic kidney disease can develop quietly.
Many people may not experience obvious symptoms during the early stages. By the time noticeable symptoms appear, kidney function may already have suffered substantial and potentially irreversible damage.
The committee said existing screening practices are largely opportunistic, meaning people are often tested when they visit healthcare facilities rather than through a systematic programme that regularly checks people at risk.
To address this gap, the panel recommended mandatory biannual kidney function testing for everyone aged 20 and above, together with annual CKD screening for high-risk individuals.
The proposed approach is intended to identify kidney problems earlier and create opportunities to slow the progression of disease before patients reach advanced kidney failure.
Who Should Be Considered High Risk?
The committee identified several groups that require particular attention.
People living with diabetes and hypertension are among the most important high-risk groups because these conditions are major contributors to chronic kidney disease.
Other groups identified for periodic screening include:
Adults aged over 60
People with a family history of kidney disease
People living with obesity
People who use tobacco
People with a previous episode of acute kidney injury
People experiencing recurrent urinary tract infections
People with recurrent kidney stones
People exposed for prolonged periods to potentially kidney-damaging medicines, including certain non-steroidal anti-inflammatory drugs
The committee also called for targeted screening among agricultural and occupational populations in areas affected by chronic kidney disease of unknown etiology, particularly parts of Andhra Pradesh, Odisha and Karnataka.
Heat stress, repeated dehydration and exposure to agricultural chemicals may contribute to kidney damage in some of these populations, making targeted monitoring especially important.
A Simple Creatinine Test May Not Be Enough
Another important recommendation focuses on how kidney function is reported after a blood test.
The committee recommended that whenever serum creatinine is tested in public or private diagnostic laboratories, the laboratory should automatically provide an estimated glomerular filtration rate report.
The panel preferably recommended the use of the CKD-EPI equation for calculating eGFR.
The reasoning is straightforward: serum creatinine alone may not provide an adequate picture of kidney function, particularly during the earlier stages of kidney disease.
Automatic eGFR reporting could give doctors additional information without requiring patients to request a separate calculation.
The committee also recommended urine albumin assessment as part of kidney-function evaluation for high-risk individuals.
Together, these measures could help healthcare professionals identify warning signs earlier and determine when further investigation or specialist referral is needed.
India’s Kidney Disease Burden Is Becoming A Bigger Healthcare Challenge
The committee cited a pooled chronic kidney disease prevalence of approximately 13.24 per cent in India.
The scale of the challenge becomes even more significant when the demand for advanced treatment is considered.
According to the report, nearly 2.2 lakh new patients with end-stage kidney disease are added every year, creating demand for approximately 3.4 crore additional dialysis sessions annually.
These numbers highlight why prevention and early detection are becoming increasingly important.
Dialysis and transplantation can be life-saving treatments, but they require substantial healthcare resources and can place significant physical, emotional and financial pressure on patients and families.
The committee therefore argued that India cannot depend predominantly on kidney replacement therapy to manage the growing CKD burden.
The bigger goal should be preventing kidney damage where possible, detecting disease earlier and slowing its progression.
Stronger Kidney Screening At Primary Healthcare Level
The panel recommended establishing a national CKD screening protocol under the National Programme for Prevention and Control of Non-Communicable Diseases.
Under the proposed approach, high-risk individuals would follow standardised screening pathways across primary healthcare facilities, including Ayushman Arogya Mandirs.
These centres could play a larger role in identifying people who may be at risk, providing lifestyle and risk-factor counselling, encouraging appropriate testing and ensuring that patients are referred when specialist care becomes necessary.
The recommendation represents a broader change in thinking.
Instead of waiting for kidney disease to become severe, the healthcare system would increasingly focus on identifying risk earlier and helping people protect their kidney function for longer.
The Focus Is Moving From Treatment To Prevention
The committee has called for a prevention-first strategy.
This includes greater public awareness, healthier lifestyles, risk-factor management, regular screening and early intervention.
For people living with diabetes or hypertension, for example, controlling these underlying conditions can be an important part of protecting kidney health.
The committee believes that early identification can also help reduce the number of people eventually requiring dialysis or kidney transplantation.
This is particularly important because kidney disease can progress silently.
A person may feel perfectly healthy while kidney function is gradually declining.
That makes regular screening especially valuable for people who have known risk factors.
Dialysis Capacity Has Expanded, But More Options Are Needed
The committee also examined India’s growing dialysis requirements.
Annual haemodialysis sessions provided under the Pradhan Mantri National Dialysis Programme have reportedly increased from approximately 25 lakh to 70 lakh over a five-year period.
While this reflects expanded access to dialysis, the panel recommended greater use of peritoneal dialysis, particularly for people living in rural and remote areas.
Expanding different forms of kidney replacement therapy could help make treatment more accessible to patients who face difficulties travelling frequently to dialysis centres.
However, the committee’s broader message remains clear: expanding treatment capacity alone will not solve the country’s CKD challenge.
Preventing disease and delaying progression must happen alongside improving access to advanced treatment.
Post-Transplant Support Needs To Continue Longer
The committee also recommended strengthening support for patients who undergo kidney transplantation.
It proposed extending post-transplant coverage under Ayushman Bharat PM-JAY from the current 15-day period to one year.
The proposed extended coverage would include follow-up consultations, essential investigations, immunosuppressive medicines and management of transplant-related complications during the first year.
Long-term follow-up is particularly important after transplantation because patients require ongoing monitoring and medication to maintain the transplanted kidney and manage potential complications.
A Digital Kidney Health System Could Improve Follow-Up
Another significant recommendation is the creation of an integrated digital CKD framework under the Ayushman Bharat Digital Mission.
The proposed framework would include electronic referral pathways, longitudinal patient records and monitoring of high-risk individuals.
The committee also recommended linking these systems to a proposed National CKD Registry.
A stronger digital system could help healthcare providers follow patients over time rather than treating every consultation as an isolated event.
It could also make it easier to identify high-risk patients who need regular testing, monitor disease progression and improve communication between primary healthcare facilities and specialists.
More Nephrology Services Are Needed
The committee recommended strengthening nephrology services at district hospitals and improving specialist referral systems.
It also called for a separate national programme focused on paediatric kidney care.
This is important because kidney disease does not affect only older adults. Children and younger patients can also develop kidney-related conditions and may require specialised diagnosis and long-term management.
Building stronger services closer to communities could help reduce delays in diagnosis and treatment.
What This Could Mean For The Public
The committee’s recommendations send a powerful message: kidney health should not become a priority only after kidney function has significantly declined.
If implemented, routine testing could help identify kidney problems earlier, particularly among people who may not have obvious symptoms.
For individuals aged 20 and above, the proposed mandatory testing framework could make kidney health monitoring a more routine part of preventive healthcare.
For people with diabetes, high blood pressure, a family history of kidney disease or other recognised risk factors, regular screening could become even more important.
However, the recommendations are proposals from a parliamentary committee. Their implementation would depend on decisions by the government and relevant health authorities.
Why Early Action Matters
Kidney disease often does not announce itself loudly.
There may be no dramatic warning in the early stages. That is precisely why prevention and screening matter.
A routine test could potentially reveal a problem before it becomes severe. Early detection can give patients and healthcare professionals more time to investigate the cause, manage risk factors and take steps aimed at slowing further kidney damage.
The parliamentary committee’s recommendations therefore represent more than a proposal for additional testing.
They reflect a larger shift in public health thinking: find disease earlier, manage risk sooner and prevent avoidable progression whenever possible.
India’s growing CKD burden makes that shift increasingly urgent.
The future of kidney care cannot depend only on dialysis and transplantation. It must also focus on protecting kidney health before patients reach the point where those treatments become necessary.
The Bigger Message For India
The proposed nationwide screening strategy places prevention at the centre of India’s response to chronic kidney disease.
From mandatory kidney function testing for adults aged 20 and above to annual screening for high-risk individuals, automatic eGFR reporting, stronger primary healthcare services, improved dialysis options and extended post-transplant support, the recommendations cover the kidney-care journey from prevention to advanced treatment.
The challenge now is implementation.
If these recommendations are translated into effective healthcare policies, they could help make kidney disease detection more systematic, improve access to testing and encourage earlier intervention.
For millions of people, the most important kidney treatment may ultimately be the one that helps prevent kidney failure from happening in the first place.
