World Kidney Cancer Day: Insights from Renal Expert Bhaskar Reddy (Part-1)
World Kidney Cancer Day—held each year on the third Thursday of June—unites patients, caregivers, and clinicians to spotlight a disease that now ranks as the world’s 14th most common cancer. Established in 2017, the observance drives education, early detection, and support for those affected. The 2025 theme, “Show Your Kidneys Some Love,” calls on communities to protect renal health through lifestyle choices, timely screening, and equitable access to care.
Against this backdrop, MedBound Times interviews Bhaskar Lakshman Reddy, a Senior Renal Physiologist at the Royal Melbourne Hospital whose 20‑plus‑year career spans India, Singapore, New Zealand, and Australia. From his early training under the legendary Dr. M. K. Mani at Apollo Hospital, Chennai, to his work with the National Kidney Foundation (Singapore) and extensive dialysis leadership in Auckland, Dr. Reddy has blended bedside care with public‑health advocacy. His focus on community screening and prevention makes him an ideal voice to discuss how we can translate kidney‑cancer awareness into concrete action—both in clinic and in the wider world.
Can you introduce yourself to our readers?
Bhaskar Lakshman Reddy: Hello, I’m Bhaskar Lakshman Reddy, a renal physiologist with almost three decades of experience in hemodialysis and kidney‑care services across India, Singapore, New Zealand, and now Australia. I trained at Dr. M. K. Mani at Apollo Hospital. I earned certification from the Board of Nephrology Examiners Nursing & Technology, and hold a Postgraduate Diploma in Public Health. Currently, I currently work as a Senior Renal Physiologist at the Royal Melbourne Hospital.
Dr. Theresa Lily: So what do our kidneys do? Why are they so important for overall health? And can you just give us a brief introduction to how the kidneys work?
Bhaskar Lakshman Reddy: Absolutely. Kidneys are a very vital part of our body. They maintain healthy bones, erythropoietin blood production, and electrolyte balance. The most important function is that they act in two ways: one, the excess fluid is excreted through the kidneys; and two, electrolytes, waste products, and toxins are removed through the kidneys. These are vital organs. So kidneys play a major role in vitamin D and erythropoietin production, and also renin, which is an enzyme the kidneys produce that controls and regulates blood pressure. If required, they reabsorb fluid or excrete it, mainly maintaining fluid balance.
Dr. Nisha Rawat: What kind of tests do you use to tell how well the kidneys are working? Do you prefer some tests?
Bhaskar Lakshman Reddy: There are three components of a basic kidney test. One is the albumin-creatinine ratio, which is a urine test. The other one is eGFR, a blood test used to measure how well the kidneys are working. If there is any damage in the kidneys with the presence of protein in the urine, obviously the eGFR will justify it. According to this, there are four stages of kidney disease: stage one, stage two, stage three, and stage four. Stage four means almost end-stage renal failure. But obviously, as people get older, kidney function will decline.
Most importantly, hypertension and diabetes are associated with renal failure anywhere in the world. So you have to check blood pressure, diabetes, and urine for the presence of protein, and also check eGFR. These are important tests.
Dr. Theresa Lily: What about that kidney function test that we take during routine blood checkups?
Bhaskar Lakshman Reddy: Yes, routine tests help to initially identify whether a person has any renal dysfunction. But once it's established that he or she has chronic renal failure or end-stage renal disease, then there are loads of blood tests, actually. That also varies from patient to patient. You have to test all the electrolytes, iron, phosphate, calcium, potassium, etc. There are many tests because renal patients are prone to anemia, hypocalcemia, or hyperkalemia, or low or high hemoglobin. Some renal diseases, like polycystic kidney disease, tend to cause higher hemoglobin levels.
Dr. Nisha Rawat: Are there signs that kidney function is declining, even when the person is feeling absolutely fine?
Bhaskar Lakshman Reddy: Yes, that's a good question. Generally, hypertension and diabetes are silent killers. So people will not realize it until it gets worse. Over the years, blood pressure and diabetes affect the vascular system, and ultimately they progress to renal failure. People generally get symptoms like swelling in the feet, breathing difficulty, fluid in the lungs, tiredness, lethargy, and loss of appetite because toxins build up in the blood. Once toxins build up, hemoglobin tends to drop because kidney function is declining. There’s less production of erythropoietin through the kidneys. It is very complex. These are the basic symptoms they experience.
Nisha Rawat: Have you come across any common kidney problems that people should be aware of?
Bhaskar Lakshman Reddy: I have worked on four continents: India, Singapore, New Zealand, and Australia. I’ve also professionally visited the United States. When you compare all these countries, hypertension, diabetes, and renal failure are common. These two major diseases are responsible for the majority of renal failure, followed by glomerulonephritis, UTIs, polycystic hemorrhage, and so on. But hypertension and diabetes are the main reasons people develop renal failure.
Dr. Theresa Lily: In the cases of diabetes and renal failure, does this occur only with uncontrolled diabetes or is it common in long-standing diabetic patients?
Bhaskar Lakshman Reddy: Good question. I will come back to you about this. I am going to talk about this particularly in terms of Indian perspective because Indians are prone to diabetes for some reason. Experts believe it may be due to kind of inheritance because when you see, India is a diabetes capital of the world now. Almost every family has a diabetic person now, unfortunately. But on top of that, people eat wrong kinds of food and do little exercise. They will automatically increase incidence of diabetes in the community. So generally, if, say, even here, men are prone because once men hit 30s or mid early 40s, so Indian men’s are prone to high blood pressure, cholesterol and diabetes also. Therefore, unfortunately, it’s in our genes and therefore one has to take note and act accordingly.
Nisha Rawat: I want to explore the basics of kidney cancer since we are talking about it for World Kidney Cancer Day. What is kidney cancer, and how is it usually discovered in patients?
Bhaskar Lakshman Reddy: Kidney cancer affects around 430,000 people globally each year. In Australia, about 4,000 people are diagnosed annually. I don’t know the exact figures for India because India does not have centralized data collection, unlike Australia and New Zealand, which have ANS data—a fantastic data system that can generate all kinds of reports.
People often don’t have symptoms until the condition worsens. Cancer is when certain cells in the kidney multiply rapidly and form a lump or tumor. When the tumor becomes bigger or worsens, symptoms appear—like hematuria (blood in the urine), continued lower back pain, tiredness, or weakness.
These are often silent until it’s too late. Many times, people go in for unrelated issues and have a CT scan of the lower abdomen. That’s when a tumor is accidentally discovered. So the diagnosis often happens by chance unless symptoms like blood in urine or continuous back pain prompt medical attention.
Nisha Rawat: What are the changes in kidney function that usually signal that something is going wrong with the kidneys?
Bhaskar Lakshman Reddy: Once you get hematuria, obviously, so which means there is something dangerous. And also, it depends upon the severity of the renal failure. Sometimes people present with swelling in the feet and tiredness, loss of appetite. And also, they may have breathing difficulty because of the presence of fluid in the lungs as kidneys are unable to excrete whatever the intake—that is retained in the body. So these may be the reasons. But what happens is, it's incremental. Sometimes people, they go for some other underlying medical condition, they go to the hospital, they go for radiology for an X-ray or some CT scan of the lower abdomen, then they might capture there is some tumour in it. So it is not the plan to look at the kidney cancer, the tumour in the kidneys. It was an accidental diagnosis. That is how a lot of people get diagnosed and treated actually. So unless the symptom worsens, as I said, the tumour gets bigger or there is presence of blood in the urine and those things or continued back pain with something they are concerned about, then they go and see their family doctor and get referred to the nephrologists. Yeah, that is how it is captured actually.
Nisha Rawat: What kind of patients are more likely to develop kidney cancer, based on age or other factors?
Bhaskar Lakshman Reddy: Patients more prone to cancer are those who smoke, have hypertension, are obese, or have a family history of cancer or kidney dysfunction. These people have a higher risk of kidney cancer.
Also, people on long-term dialysis are more prone due to age and immunocompromised conditions. Men are more prone than women, when you look at gender differences.
Transplant patients, who are on long-term immunosuppressive medications, are also at some risk. Not everyone, but a small percentage, may develop cancer due to these medications. I do know a patient in New Zealand who had a transplant and was on these medications and unfortunately developed cancer.
Dr. Theresa Lily: So that happens in the newly transplanted kidney, right?
Bhaskar Lakshman Reddy: Kidney-transplanted patients who are on immunotherapy, who are on anti-rejection medications for the long term. So they are prone to get it, but not everybody.
I do know somebody in New Zealand, my patient who had a transplant, unfortunately was on this medication and got cancer.
Dr. Theresa Lily: Can kidney cancer be picked up during routine checkups?
Bhaskar Lakshman Reddy: Yes, sometimes. If the patient undergoes imaging like MRI or CT for another reason, a tumor might be spotted. But CT and MRI scans often use contrast dye, which can be harmful to kidneys. That’s why renal function must be checked before administering contrast. If kidney function is already low, a nephrologist should be consulted. Some of these dyes contain metals that may harm the kidneys, especially the blood vessels, which can lead to further decline in kidney function. These nephrotoxic substances should only be used under guidance. Ultrasound or contrast-enhanced imaging can help detect tumors without causing harm if handled carefully. Sometimes, there’s no other option but to use these tools to detect tumors effectively.
