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The Parliamentary Panel on Health and Family Welfare has recommended to the ministry of health to review the regulatory and awareness measures on over-the-counter availability and irrational use of nephrotoxic medicines, as a measure to address the issues related to indiscriminate and unsupervised use of these medicines.
The Panel, in its 177th report on prevalence of chronic kidney disease in India - prevention, diagnosis, treatment and management, presented in the Rajya Sabha recently, observed with concern that indiscriminate and unsupervised use of non-steroidal anti-inflammatory drugs (NSAIDs) and other nephrotoxic medications continues to contribute to preventable kidney injury in the country.
The Panel also observed that limited public awareness regarding the potential adverse effects of prolonged self-medication and inadequate regulation of inappropriate drug use remain important public health concerns, particularly in rural and underserved areas.
"The Committee is of the considered view that prevention of drug-induced kidney disease requires a combination of public awareness, rational prescribing practices and effective regulatory oversight," said the panel headed by Member of Parliament Prof. Ram Gopal Yadav.
"The Committee, therefore, recommends that the ministry of health and family welfare, in consultation with the Central Drugs Standard Control Organisation (CDSCO), review existing regulatory and awareness measures relating to over-the-counter availability and irrational use of nephrotoxic medicines".
It further recommended that appropriate public education campaigns be undertaken to sensitise citizens regarding the risks associated with indiscriminate use of painkillers and other potentially nephrotoxic medications.
The government should also undertake effective measures to regulate the indiscriminate use of antibiotics as the same exert lethal impact on kidney health, therefore, the Committee desires that a robust, science driven and evidence based policy is essential to address such growing threat, it added.
Individuals in the principal high-risk groups such as those with diabetes mellitus and hypertension should undergo regular kidney function assessment, preferably on an annual basis, to facilitate early detection and timely intervention.
Other priority groups include adults above 60 years of age; individuals with a family history of kidney disease; persons with obesity or tobacco use; and individuals with a history of acute kidney injury (AKI), recurrent urinary tract infections, recurrent kidney stones or prolonged exposure to nephrotoxic medications, including non-steroidal anti-inflammatory drugs (NSAIDs), said the Panel.
Taking this into account, immediate increasing significance of screening should be conducted among occupational and agrarian populations residing in regions affected by Chronic Kidney Disease of Unknown Etiology (CKDu), particularly in parts of Andhra Pradesh, Odisha and Karnataka.
It noted that the public awareness is generally restricted and limited to diabetes and hypertension as risk factors, whereas knowledge regarding other causes such as congenital and hereditary kidney disorders, obesity, unhealthy dietary practices, excessive consumption of salt and ultra-processed foods, indiscriminate use of painkillers and other nephrotoxic drugs, recurrent urinary tract infections, environmental and occupational exposures remains inadequate.
The Panel also observed that misconceptions regarding kidney disease and the absence of dedicated public awareness campaigns have resulted in poor health-seeking behaviour and delayed diagnosis.
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