World Kidney Day: Addressing the Growing Burden of Kidney Diseases in Pakistan, with a Focus on Balochistan
World Kidney Day: Addressing the Growing Burden of Kidney Diseases in Pakistan, with a Focus on Balochistan
By Arbaz Khan Tareen
On this World Kidney Day, it is crucial to highlight the increasing burden of kidney-related diseases in Pakistan, particularly in Balochistan. Kidney diseases, especially Chronic Kidney Disease (CKD), have become a major public health concern, with rising cases due to lifestyle habits, socio-economic conditions, and inadequate healthcare facilities. While the government and private institutions have taken some steps to combat these diseases, significant gaps remain in awareness, accessibility, and affordability of treatment.
Kidney diseases affect millions worldwide, and Pakistan is no exception. Studies suggest that CKD prevalence in Pakistan ranges between 12.5% and 31.2%, with major contributing factors including diabetes, hypertension, poor dietary habits, dehydration, and exposure to environmental toxins. Balochistan, in particular, suffers from additional challenges such as limited healthcare infrastructure, poor sanitation, and lack of clean drinking water, all of which contribute to the rising number of kidney-related ailments.
One of the major obstacles in tackling kidney diseases is the lack of awareness among the general public. A study conducted in Quetta found that many patients had little understanding of CKD, its causes, medication, and necessary laboratory tests. Another survey across Pakistan found that 81.8% of respondents had moderate awareness of kidney failure, while 18.2% had no knowledge at all. Only 26.5% could identify all major risk factors, and just 25.4% knew about dialysis as a treatment option. In Balochistan, particularly in rural areas, there is a misconception that kidney diseases occur only in old age or as a result of genetic predisposition. This lack of knowledge leads to delayed medical intervention, worsening the condition and increasing the financial burden on families.
Healthcare facilities for kidney patients in Pakistan, particularly in Balochistan, remain inadequate despite the growing need. The Balochistan Institute of Nephrology and Urology Quetta (BINUQ) is one of the few specialized centers providing kidney treatments, including dialysis and transplants. The institute has successfully completed over 38 transplants and 2,950,000 dialysis sessions, serving approximately 115 dialysis patients daily. Additionally, in 2018, a free kidney treatment facility was inaugurated in Quetta, treating around 60 patients daily, with an additional 45 patients receiving haemodialysis at no cost. While these initiatives are commendable, they are not enough to meet the rising demand. The cost of a single dialysis session is around Rs6,000 ($50), and patients with chronic kidney failure require two to three sessions per week, making treatment financially unsustainable for many families.
The government has introduced some initiatives to curb kidney diseases, particularly through the Sehat Sahulat Program. Launched in 2015, this social health insurance program provides free healthcare services, including treatment for end-stage renal disease, dialysis, organ failure, and chronic infections. As of November 2023, the program has enrolled approximately 43 million families, covering 190 million individuals, with 14.6 million patients utilizing the scheme. However, despite these efforts, a third-party validation report found that 33% of patients under the Sehat Sahulat Program still had to pay out-of-pocket expenses, indicating gaps in coverage and implementation. Furthermore, Balochistan remains underfunded in the healthcare sector, with many rural areas lacking even basic medical facilities.
Apart from lifestyle choices, environmental and socio-economic conditions play a critical role in the high prevalence of kidney diseases. In Balochistan, access to clean drinking water is limited, forcing people to consume contaminated or unfiltered water, which increases the risk of kidney stones and infections. Agricultural workers and miners are often exposed to environmental toxins, which further contribute to kidney dysfunction. A study on rural Pakistan identified “unknown etiologies and kidney stones” as the most common causes of CKD. These findings suggest that environmental and occupational hazards are major risk factors, and immediate action is needed to address them.
Given the high prevalence and poor awareness, urgent steps must be taken to educate the public about kidney health. Awareness campaigns should focus on encouraging early screening and regular kidney function tests, promoting hydration and healthy dietary habits, educating people about the dangers of excessive painkiller use and self-medication, highlighting the importance of managing diabetes and hypertension, and providing information about free treatment centers and financial assistance programs.
To effectively combat kidney diseases in Balochistan and Pakistan as a whole, a multi-pronged approach is required. First, investment in healthcare infrastructure must be increased, with more dialysis centers and kidney transplant facilities established, especially in remote areas. Second, the Sehat Sahulat Program should be expanded to ensure full financial coverage for kidney patients and reduce out-of-pocket expenses. Third, public awareness should be improved through nationwide campaigns in collaboration with media outlets, hospitals, and educational institutions. Fourth, clean drinking water must be ensured by investing in water filtration plants to prevent kidney diseases caused by water contamination. Finally, more research and training should be promoted to advance medical knowledge on CKD and enhance healthcare professionals’ capabilities.
On this World Kidney Day, it is imperative to recognize the growing burden of kidney diseases in Pakistan, particularly in Balochistan. While some progress has been made, there is an urgent need for stronger policies, increased healthcare funding, and widespread awareness campaigns. Without these crucial interventions, kidney diseases will continue to claim thousands of lives each year, placing a heavy burden on families and the healthcare system. The time to act is now. A healthier future for Pakistan starts with better kidney care.
