Kidney Disease: The Silent Killer You May Not See Coming

No Pain Does Not Mean Your Kidneys Are Healthy

Kidney disease is often called a “silent killer” because it can progress for years without producing obvious symptoms. By the time many patients realise that something is wrong, significant damage may already have occurred.

In a conversation with Sakshi Post, Dr. Sri Bhushan Raju, Professor and Head of the Department of Nephrology at NIMS, explained why kidney disease can remain hidden for years and why people should not wait for symptoms before getting evaluated.

One common misconception, he pointed out, is that passing urine automatically means the kidneys are functioning normally. Even people with severely damaged kidneys, including those undergoing dialysis, may continue to produce urine. Similarly, back pain should not automatically be assumed to be a sign of kidney disease, as many cases of back pain are related to bones and muscles.

Why Kidney Damage Can Go Unnoticed

The kidneys perform several vital functions beyond simply producing urine. They filter waste products from the blood, regulate fluids and minerals, contribute to blood-pressure regulation and play an important role in maintaining healthy bones.

According to Dr. Raju, kidney damage can remain unnoticed until a substantial proportion of kidney function has been lost. Changes caused by kidney disease can also affect other parts of the body, including the heart, brain, blood vessels, muscles and bones.

This is why waiting for obvious symptoms can be risky. Early detection, he stressed, gives doctors a better opportunity to slow the progression of kidney disease and prevent complications.

Diabetes and High Blood Pressure: Major Kidney Threats

Diabetes has emerged as one of the major causes of kidney damage seen in clinical practice. Dr. Raju said that doctors are increasingly seeing younger people develop diabetes and subsequently develop kidney problems.

High blood pressure is another major warning sign. Particularly when hypertension develops at a younger age, kidney evaluation becomes important because kidney disease itself can also contribute to high blood pressure.

Other causes mentioned in the interview include hereditary kidney disorders, kidney stones, infections, obesity and certain medications.

Don't Ignore Kidney Stones

Kidney stones may appear to be a relatively small problem, but leaving them untreated can sometimes cause serious damage.

Dr. Raju cautioned against simply ignoring a stone or relying on unverified remedies while allowing it to remain in the urinary tract. Persistent obstruction can increase pressure on the kidney and eventually damage kidney function.

The key message is simple: a kidney stone should be medically evaluated rather than neglected.

The Hidden Danger of Self-Medication

Another concern is the casual use of medicines without medical supervision.

Painkillers, antibiotics and medicines commonly taken for gastric problems may not be harmless when used unnecessarily or for prolonged periods. According to Dr. Raju, some medicines can affect the kidneys, while others may cause problems involving the liver, skin or other organs.

His advice is straightforward: medicines should be taken under appropriate medical guidance, rather than being repeatedly used because a particular tablet helped someone else.

Are “Kidney Detox” Drinks Really Necessary?

Social media is flooded with products and claims promising to “detox” the kidneys.

Dr. Raju cautioned people against blindly believing such claims. The human body has sophisticated mechanisms for maintaining its internal balance, and kidney health should not be approached through unscientific shortcuts.

He also warned that various alternative remedies and even some conventional medicines can potentially harm the kidneys. Anything consumed as food, a supplement or medicine should therefore be considered carefully rather than assumed to be safe simply because it is marketed as “natural” or “detoxifying.”

Protein Supplements and Gym Culture: When “More” Can Become a Problem

The growing obsession with rapid muscle gain is another area of concern.

Many young people begin gym workouts hoping to transform their bodies within a short period. Protein supplements, creatine and other products may become part of this pursuit.

Dr. Raju stressed that not everyone who consumes such products will necessarily develop kidney problems. However, some individuals may have underlying vulnerability or weaker kidney function that they do not know about. Excessive or inappropriate supplementation can therefore become risky for susceptible people.

His advice to young gym-goers is not to chase instant physical transformation. A balanced diet and gradual, consistent exercise can help build a healthy body without unnecessary dependence on supplements.

Kidney Disease Can Affect Children Too

Kidney disease is not exclusively a problem of older adults.

The interview highlighted that kidney abnormalities can sometimes be detected even before birth through antenatal scans. Kidney disorders can also occur in infants and young children, and in severe cases children may require dialysis or other specialised treatment.

Therefore, kidney disease should not be dismissed simply because a person is young.

When Should You Get Your Kidneys Checked?

There is no single age at which everyone must undergo the same kidney tests. Instead, the need for evaluation should depend on an individual's risk factors and health background.

People with a family history of kidney disease, diabetes, hypertension or other long-term health problems may need earlier or more regular evaluation. Dr. Raju emphasised that medical screening should be tailored to an individual's vulnerability rather than following a blanket rule for everyone.

The important principle is early detection rather than waiting for symptoms.

Diabetes Does Not Automatically Mean Dialysis

A common fear among people with diabetes or hypertension is that kidney damage is inevitable and dialysis is unavoidable.

Dr. Raju clarified that while diabetes and hypertension significantly increase the risk of kidney disease, this does not mean every person with these conditions will inevitably reach kidney failure.

The important step is to control the underlying condition and periodically monitor the health of organs that may be affected.

Dialysis Is Not a Failure of Treatment

Dialysis is sometimes viewed with fear or as a sign that treatment has failed. Dr. Raju described dialysis as one of the major achievements of modern medical science and noted that it has been helping patients for decades.

The interview also emphasised that transplantation can be an important option for suitable patients, but it should be considered carefully, based on medical evaluation and the patient's overall physical, psychological and social circumstances.

Kidney Transplantation: Don't Rush Into Decisions

A kidney transplant is a major medical decision and should not be pursued through illegal or unsafe shortcuts.

Dr. Raju advised patients and families to discuss transplantation thoroughly with their medical team and make decisions after understanding the benefits, risks and long-term implications. Legal organ-transplant systems and established programmes exist to facilitate transplantation safely.

For living donors, extensive medical evaluation is performed before donation to determine whether donating a kidney is reasonably safe for them.

Organ Donation: A Gift That Can Save Lives

The discussion also turned to organ donation.

Dr. Raju stressed that organ donation is not merely a medical issue but a social responsibility. Families of brain-dead patients may have to make the decision to donate organs at one of the most painful moments of their lives. Yet such decisions can potentially give another person a chance at life.

He called for stronger awareness about organ donation across society, including schools, colleges, workplaces and public institutions. The goal, he said, should be to create a culture in which people understand that organ donation after death can help others live.

Five Simple Habits for Better Kidney and Overall Health

Dr. Raju's message was that kidney care cannot be separated from overall health. His practical recommendations include:

1. Stay physically active

Regular physical activity and walking help keep the body and its organs healthy.

2. Avoid dehydration

Adequate fluid intake is important, particularly in hot climates such as India. However, there is no universal rule that every person must drink exactly the same number of litres every day. Fluid needs depend on the individual's circumstances and environment.

3. Use salt sensibly

Salt should neither be consumed excessively nor eliminated unnecessarily. A balanced approach is important.

4. Get adequate sleep

Good-quality sleep is an important part of maintaining overall health.

5. Avoid unnecessary medicines and monitor your health

Do not routinely take medicines without appropriate medical advice. People with relevant risk factors should undergo health checks at suitable intervals.

Don't Wait for Your Body to Sound the Alarm

The biggest takeaway from the discussion is that kidney disease does not always announce itself loudly.

By the time symptoms become obvious, the disease may already have progressed considerably. Regular medical evaluation for people with relevant risk factors, responsible use of medicines, a healthy lifestyle and timely treatment of conditions such as diabetes, hypertension and kidney stones can all play an important role in protecting kidney health.

As Dr. Raju's message makes clear, looking after the kidneys is not about protecting one organ in isolation. A healthy kidney is part of a healthy body—and caring for the body as a whole is the best long-term investment in health.