Imagine living with a disease that requires you to undergo treatment two to three times a week, for nearly four hours at a stretch. This is the harsh reality for millions of people living with chronic kidney disease (CKD) in India. For patients like Dhian Singh from Ludhiana, dialysis is a constant reminder of their illness.

Dhian's story is not unique. With over 1 lakh free dialysis sessions provided by the Punjab government under its Sehat Yojna initiative, more and more patients are getting access to life-saving treatment without having to break the bank. But experts warn that this is just the beginning – early detection remains the biggest challenge in India's fight against CKD.

CKD is a silent killer that creeps up on people over years, silently damaging kidney function before symptoms appear. And when they do, it's often too late. The disease is closely linked to the rising burden of diabetes and hypertension, and public health experts estimate that hundreds of thousands of patients progress to end-stage kidney disease each year, requiring either long-term dialysis or kidney transplantation to survive.

In India, the crisis is compounded by cost. A single haemodialysis session can cost between ₹1,500 and ₹4,000 in the private sector, making it inaccessible to most families. It's a stark reminder that treatment decisions are often shaped as much by economics as by medical need. But it's not just the cost – it's the access.

Government-supported programmes like the Mukh Mantri Sehat Yojna in Punjab are playing a critical role in preventing treatment discontinuity. Under the scheme, dialysis services are offered free of cost in government and empanelled private hospitals, reducing out-of-pocket expenditure that earlier forced many patients to skip or delay sessions. And it's working – nephrologists like Dr Sourav Goyal from Delhi Heart and Multispeciality Hospital, Moga, are seeing a significant increase in patients accessing cashless dialysis treatment.

But Dr Goyal also highlights the importance of early detection. 'Most patients are diagnosed very late, when kidney function is already severely compromised,' he says. 'At that stage, options are limited to dialysis or transplant.' Medical research consistently shows that a significant proportion of CKD patients in India face catastrophic health expenditure, with families often exhausting savings or falling into debt within months of starting treatment.