Across Telangana, doctors are battling a problem that is becoming increasingly common: kidney failure. These patients are young, many are the breadwinners of their families, and most do not have the usual risk factors of chronic kidney disease (CKD), which are diabetes and hypertension. Then why are their kidneys failing?
Even as researchers continue to examine the drivers of this pattern and nephrologists struggle to save patients, a paper published last year, may perhaps point to one of possible answer: the growing number of patients consuming self-prescribed alternative medicines. While the link has not yet been scientifically established, this is a line of inquiry researchers now want to pursue. It may be noted that certain alternative medicines have been implicated in liver injuries in India.
The study
The study, led by nephrologists from Osmania General Hospital and Apollo Hospitals, examined 75 patients and was published in the Indian Journal of Nephrology in August 2024. Conducted between March 2021 and November 2022 at Osmania General Hospital, it was a single-centre, prospective observational study documenting the clinical and epidemiological profile of patients with chronic kidney disease of unknown aetiology in Telangana and assessing their kidney histology.
Among the 75 patients, the mean age was 41.7 years and 68% were men. A majority, amounting to 77.3%, relied on groundwater as their primary drinking water source. 40% reported having used alternative medicine in the past and 46.6% underwent kidney biopsies as part of the evaluation.
What the study found
Manisha Sahay, professor and head of the nephrology department at Osmania General Hospital and one of the authors of the study, said many patients who report using alternative medicine had taken these substances without medical guidance. “Patients often rely on suggestions from friends or unlicensed quacks who do not hold any degree in any recognised system of medicine. In most instances, they do not have a prescription and consume these products in the form of powders, liquids, leaves or tablets, often supplied in unnamed bottles.”
Dr. Sahay further added that even when patients mention alternative medicine use, they rarely bring samples for analysis, making it difficult to establish a clear link between the substances consumed and the kidney damage observed. Although 40% of those studied reported past use, the absence of traceable samples meant the cause and effect relationship cannot yet be established, but the team is pursuing this line of research.
The histological analysis in the study revealed that 44% of the patients had global glomerulosclerosis, which indicates that more than half of the kidney’s filtering units were scarred and non-functional.
No traditional risk factors
Dr Sahay said the main finding was that patients with chronic kidney disease who fit the phenotype for chronic kidney disease of unknown aetiology, as defined in known hotspots elsewhere, are not uncommon in Telangana. She said the cases are not confined to people with traditional risk factors such as agricultural work and that this is the first report documenting the presence of such cases in the State.
Most participants were from Hyderabad, accounting for 42.7%, followed by 10% from Rangareddy district. About one-third, or 33%, had hyperuricemia, which refers to elevated uric acid levels in the blood. Of the patients, 40% had already reached stage five chronic kidney disease at the time of diagnosis, and seven patients, representing 9.3%, required renal replacement therapy such as dialysis when they were evaluated.
What doctors say
While more research is needed across the State to establish definitive links, this practice combined with the deep-rooted menace of quackery in the State has now led to calls by medical professionals to both clamp down on all illegal and unsafe medical practices.
G. Srinivas, Vice-Chairman of the Telangana Medical Council (TGMC), said that unqualified practitioners prescribing unregulated herbal or alternative medicines pose a serious risk to patients’ kidney health. “Many of these substances are given without any knowledge of dosage, strength or side effects. We do not know how much of these medicines people are consuming, what the mechanism of action is, how they are metabolised in the liver or kidneys, or what enzymes are involved. We also do not know how these substances interact with the medicines that patients may already be taking for conditions like hypertension or diabetes,” he said.
According to him, such interactions can lead either to excessively rapid metabolism, which causes the drug to be cleared too quickly, or to slow metabolism, which results in the accumulation of the substance in the blood. “Slow metabolism causes the drug to build up in the body and this can damage internal organs, including the liver, kidneys and even the brain.
He added that irrational prescribing by quacks is a known contributor to kidney failure in peripheral and rural areas. “In many places, unqualified practitioners give combinations like dexamethasone and diclofenac sodium as injections for quick pain relief. These drugs directly damage the nephrons and can lead to kidney failure,” he said.
“Patients must consult only licensed experts and follow prescriptions that clearly mention the name of the medicine along with the credentials of the practitioner,” said Dr. Sahay.
Published – December 05, 2025 06:00 am IST
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