Genes make our physical and mental makeup. We are the result of family genes that are passed on to us by our parents. Our genes can increase the risk of certain diseases or protect us from certain health conditions. Currently, more than 60 genetic diseases are known to affect the kidneys directly or indirectly. Renal failure or Kidney failure can be hereditary, however not everyone who has a close family member with chronic kidney disease, will develop renal failure.

Genetic Variants and Kidney Risks

There are a few genetic variants that are linked to an increased risk of kidney diseases. Hereditary renal failure is possible if genetic variations like MYH9 and APOL1 are part of your body make-up. This means that merely having these genes will not make you susceptible to chronic kidney disease however it can increase the risk of renal failure if you have some other pre-existing condition like diabetes or high blood pressure. For eg: It is seen that APOL 1 appears to increase the risk of end stage kidney disease in patients with high blood pressure.

Conditions like diabetes and high blood pressure run in family. You may be at a higher risk if your close family member has these conditions. These hereditary diseases can in turn affect the kidney’s health as the disease progresses.

Is renal failure hereditary in India?

Detailed studies related to hereditary diseases based on ethnicity are underway; however considering the other factors that can cause renal diseases, it can be considered that kidney diseases are hereditary.

The other factors that up the risk of Renal Diseases in India are :

• 28% of children born weigh less than 2.5 kg at birth.
• Hypovitaminosis A and other nutritional issues during pregnancy may cause smaller kidney volume at birth and lower eGFR.
• Marrying within family or genetic inbreeding increases the risk of kidney and urinary tract anomalies.
• Poverty, poor sanitation, pollutants, water contamination etc. can cause glomerular and interstitial kidney diseases.
• By 2030, India is expected to have the world’s largest population of patients with diabetes. This will in turn add to the number of kidney patients as diabetes is known to cause renal failure in patients.

So while these are not genetic, many of these reasons end up causing hereditary renal failure in the population.

Why do people with certain genetic variants develop kidney disease?

Kidney disease and its progression can be the result of three underlying factors. One is the existence of other diseases. Other is individual lifestyle choices that a person makes and finally the genetic make-up.

Factor 1

Other diseases that can increase the risk of renal failure

1. Diabetes
2. High Blood Pressure
3. Obesity

Factor 2

1. Individual choices
2. Unhealthy eating habits
3. Alcohol and Substance Abuse
4. Lack of exercise
5. Smoking

Factor 3

Genetics

1. MYH9
2. APOL1

Only when all three factors are present in a person’s life can we consider that renal failure is hereditary.

Simple steps that can be taken by an individual to keep renal failure at bay

If you are aware of close family member suffering from diseases like Diabetes or High blood pressure, it is important to stay vigilant and follow an active lifestyle. Regular check-up, healthy eating habits, staying active and refraining from alcohol, smoking or substance abuse can help a person keep kidney disease at bay. As the chronic kidney disease does not show any symptoms till the disease progresses significantly, it is important for the individual to take proactive steps and maintain kidney health.

Why proactive steps in kidney care are essential in India?

Apart from the reasons discussed above, one of the major concerns in India is the shortage of nephrologists in India. It is shocking but true that for treating the 1.3 billion people in India, we have only 1850 nephrologists. Another worrying reason that might not give a clear indication of kidney diseases and its spread is the rural and urban divide. The knowledge about kidney health is not prevalent in rural areas and the patients come for treatment only when the condition worsens. Accessibility of dialysis centers too is another concern.

Wrapping Up

There is no simple answer for the question of ‘Is renal failure hereditary.’ The disease is not caused just because you have a particular gene, however when compounded with other factors it can up your risk for renal failure. With low awareness and lack of nephrologists, it is important to take proactive steps and monitor your kidney health if you fall in the high risk category. Maintaining good health and making smart lifestyle choices are an important step in that direction.