In a new study published in the Journal of the American Geriatrics Society, researchers analyzed 15 years of data from 3,094 older persons in Sweden and concluded that the number and type of chronic illnesses have a direct impact on the likelihood and severity of a decrease in kidney function.  The findings are especially important in South Asia, where high rates of diabetes, hypertension, and other chronic diseases are already pressuring public health systems.

The study found that older persons with cardiometabolic diseases, such as diabetes and hypertension, experience the sharpest reduction in kidney function. In South Asia, these circumstances are prevalent. According to the International Diabetes Federation, the region is responsible for about one-fifth of the global diabetes burden, with over 77 million adults affected in India alone. Hypertension is equally common, affecting approximately 30% of individuals in nations such as Bangladesh and Sri Lanka.

The study's co-author, Dr. Giorgi Beridze, MD, MMSc, from Karolinska Institute, emphasized, "Our findings highlight the need for comprehensive assessments that consider both the overall chronic disease burden and the interactions between diseases when evaluating the risk of kidney function decline in older adults."

Chronic kidney disease (CKD) is becoming a major health concern in South Asia, owing to the region's high incidence of risk factors. According to urban research, roughly 17% of the Indian population suffers from CKD, with rural rates slightly lower but nonetheless alarming. Diabetes, hypertension, limited healthcare access, and lifestyle factors that exacerbate kidney-related issues combine to cause this prevalent problem.

The study focuses on how multimorbidity patterns affect kidney health, highlighting the urgent need for tailored therapies in South Asia.

The findings revealed that people with cardiometabolic diseases, such as diabetes and hypertension, experienced the steepest reduction in kidney function. This is particularly concerning for South Asia, where the prevalence of high-carbohydrate and salt diets makes control of these illnesses more challenging. According to studies, over 60% of diabetics in the region have CKD. The combination of poor glycaemic management and high blood pressure causes a vicious cycle of kidney injury, making this population particularly vulnerable.

Individuals with various illnesses, such as obesity and inflammatory diseases, are also a cause for concern because they hasten renal decline. South Asia's urbanization has resulted in an increase in obesity rates, particularly among the elderly.  This, along with chronic inflammation from illnesses such as arthritis, generates a cumulative effect that raises the risk of kidney injury. Furthermore, polypharmacy, a common practice in the treatment of numerous disorders, may expose patients to nephrotoxic medicines, thereby exacerbating the risk of kidney injury.

Surprisingly, people in the low-burden category exhibited slower declines in renal function. These participants frequently had milder diseases, such as managed hypertension and dyslipidaemia, which are common among younger members of South Asia's ageing population. The slower course is promising, but it emphasizes the significance of early intervention in managing even minor symptoms before they worsen.

The study also discovered a pattern of psychiatric and respiratory illnesses, such as depression and asthma, that were not associated with considerable renal function deterioration. Untreated mental health concerns, however, continue to pose a significant burden throughout South Asia due to social stigma and inadequate access to mental health resources. Addressing these concerns is critical, as untreated psychiatric problems can have an indirect impact on general health and treatment adherence.

Interlinking these studies illustrates the complex interaction between lifestyle factors, healthcare availability, and illness trends in South Asia. Cardiometabolic disorders emerge as the most serious concern, but obesity, inflammation, and prescription abuse all contribute to kidney health problems. Meanwhile, addressing mental health issues may enhance overall healthcare results by emphasizing the necessity of taking a comprehensive approach to CKD management.

As South Asia's population ages, prioritizing these findings could help reduce the growing CKD burden while improving health outcomes and quality of life for millions.

The study's findings emphasize the critical need for South Asian healthcare systems to prioritize chronic disease management among older people.  Currently, access to nephrology services and CKD screening is limited, especially in rural areas. Polypharmacy, which is frequent in older persons with numerous illnesses, can also result in nephrotoxic medication exposure, which exacerbates kidney decline.

To address the rising health crises caused by chronic illnesses and their influence on renal function, experts emphasize the importance of a multifaceted strategy. Regular kidney function testing is critical for high-risk populations, particularly those with diabetes and hypertension, because early identification can help prevent long-term harm. Lifestyle therapies play an important role in both prevention and management. Public health initiatives promoting balanced diets, regular exercise, and smoking cessation are critical for lowering the prevalence of risk factors related to renal impairment. Additionally, guaranteeing inexpensive healthcare is critical, particularly in underprivileged communities where access to medications and consultations is sometimes limited. Subsidized healthcare services can close these gaps, making preventative care and treatment more accessible to underprivileged groups and eventually lowering the burden of renal disease.

 "Individuals with high-risk multimorbidity patterns could benefit greatly from increased kidney monitoring and timely interventions," says Dr. Beridze.

With South Asia's population of 60 and older expected to triple by 2050, addressing kidney health concerns is critical for regional stability. Geriatric health policies must develop to meet the diverse requirements of older persons with multiple diagnoses. Initiatives such as India's National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) may serve as a model for incorporating kidney health into overall chronic illness management.

By tailoring the study's findings to local conditions, South Asia has the potential to reduce the twin burden of ageing and chronic illnesses, resulting in healthier lives for its ageing population.