Published Jun 14, 2026 | 11:06 AM ⚊ Updated Jun 14, 2026 | 11:17 AM
High creatinine levels can indicate a possible kidney problem. (Creative Commons)
Synopsis: Telangana records India’s highest chronic kidney disease mortality rate at nearly 20 deaths per lakh, a new study finds, despite moderate case numbers. Diabetes and hypertension drive deaths, while Kerala and Tamil Nadu show far better outcomes. Doctors flag late detection, especially in younger patients, as a key gap.
A study published in the Indian Journal of Medical Research has found that Telangana recorded the highest chronic kidney disease mortality rate in India: 19.84 deaths per lakh population in 2023.
Rajasthan recorded the lowest mortality rate, at 6.71 deaths per lakh, nearly three times below Telangana’s figure.
The study, however, found that Telangana did not record the highest number of new chronic kidney disease (CKD) cases in India. Its incidence stood at 241.57 per lakh, while Haryana led with 316.35. Telangana’s case numbers were close to the national range.
Yet, Telangana recorded the highest disability-adjusted life years (DALY) in India, at 666.38 per lakh, a measure combining years lost to premature death and years lived with illness. Rajasthan recorded 312.21, less than half.
“High-burden states such as Telangana and Punjab maintained CKD rates significantly above the national mean across all metrics,” the authors wrote.
“In high-SDI states, CKD is managed as a chronic long-term condition, whereas in low-SDI states, CKD disproportionately translates to premature mortality and disability due to late presentation and treatment inaccessibility,” the study noted.
Telangana’s figures put the state at a mid-to-upper range on India’s socio-demographic index, a composite measure of income, education and fertility used as a proxy for development.
The study found that states with similar development levels often achieved lower mortality despite higher case numbers, through earlier diagnosis and sustained treatment access. Telangana, however, showed a different pattern.
“Widening uncertainty bands around mid-level SDI states suggest a stalled epidemiological transition, where health gains have not matched socioeconomic improvements,” the authors wrote.
The research, conducted by Dr Hari Shankar Meshram of the Institute of Liver and Biliary Sciences in New Delhi, along with Sanshriti Chauhan and Saurabh Puri, drew on the Global Burden of Disease 2023 database and covered all Indian states and Union Territories from 1990 to 2023.
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Southern India showed the sharpest internal contrast in the study.
Kerala recorded 9.1 deaths per lakh and Tamil Nadu 9.83, both less than half of Telangana’s rate. Both states were in the study’s low burden bracket, a declining trend category across incidence, prevalence and mortality.
Kerala’s mortality rate declined at 1.6 percent annually since 1990, and Tamil Nadu’s at 1.83 percent, against a national decline rate of 0.9 percent. The study compared it with China, which has a national kidney disease registry and subsidised dialysis programmes and declines at 1.6 percent annually. Kerala matched China’s pace. Tamil Nadu surpassed it.
“Kerala and Tamil Nadu exhibited lower mortality and DALY rates despite high prevalence, reflecting improved survival and health system maturity,” the authors wrote.
Andhra Pradesh recorded 11.64 deaths per lakh, around 40 percent below Telangana, despite sharing similar diet, language and diabetes risk factors with its neighbour. The state figured in the high burden category, declining trend cluster, with mortality declining at 0.82 percent annually, slightly faster than Telangana’s 0.69 percent.
Karnataka recorded 13.34 deaths per lakh, above the national average and above its three southern neighbours, barring Telangana. The state’s incidence, at 220.55 per lakh, ranked among the lowest in the south, echoing Telangana’s pattern of moderate case numbers paired with elevated deaths.
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The study found that diabetes accounted for the largest share of Telangana’s excess mortality.
The state recorded the highest diabetes-related chronic kidney disease mortality burden in India. Type-2 diabetes contributed to 25 percent of kidney disease deaths in Telangana, the highest proportion among all states. Type-1 diabetes accounted for 6.6 percent of new cases in the state, also the highest nationally.
Dr Mohammad Jahangir, Assistant Professor of Urology at Osmania Medical College, said diabetes and hypertension remained the primary drivers behind rising case numbers, but detection often happened by chance.
“We usually detect it incidentally,” he told South First. “If a patient comes with burning micturition or a urinary infection, then we get a complete urine examination done. The protein may come out to be two plus or three plus, and we incidentally detect kidney damage.”
He said the basic screening tools, a urine protein test and a blood creatinine reading, were often unused in younger patients because of the doctors’ approach to age-based screening.
“Kidney diseases are considered rare in the young population. This is the perception among many physicians. So they do not routinely evaluate the kidneys,” he said. “In older age, after 50 years, if a patient comes for a general check-up, physicians evaluate the kidneys because the patient is older.”
He said this gap persisted despite a rise in cases among younger patients. “Young patients are also developing chronic kidney disease. We have many young patients with CKD,” he said, citing conditions such as IgA nephropathy, where the immune system damages the kidney.
He also pointed to rising hypertension among younger patients as a growing concern. “We are seeing more hypertension in younger patients. When a 30-year-old has high blood pressure, we conduct further investigations such as a renal Doppler study and other tests to determine the reason.”
Nationally, the study found that hypertension-related chronic kidney disease accounted for a disproportionately high share of deaths relative to how many patients carry the condition. The authors described this pattern as indicating poor prognosis and the need for earlier intervention.
A large share of chronic kidney disease cases across India fell under causes that the study classified as other or unspecified. These accounted for 66.4 percent of incidence and 67.9 percent of prevalence nationally, though a smaller share of deaths, at 38.4 percent. The authors said it pointed to diagnostic gaps that vary by state.
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The authors said chronic kidney disease remained absent from India’s National Programme for Prevention and Control of Non-Communicable Diseases, despite the scale of its burden.
“CKD must be urgently integrated into India’s national NCD strategy with priority financing for dialysis and transplantation under Ayushman Bharat,” they wrote. “State-specific CKD surveillance and registries are essential for tailoring interventions to varying epidemiological profiles. Early detection programmes must be decentralised to primary care settings, particularly in low-SDI states, with emphasis on diabetes and hypertension control.”
“Without these actions, India risks a widening CKD treatment gap that disproportionately affects disadvantaged populations,” the authors said.
(Edited by Majnu Babu).
