Kidney disease rarely announces itself. It builds quietly in people with diabetes and hypertension, and by the time symptoms appear, damage that cannot be reversed has often already been done. Dr. Sanjeev Kumar Hiremath, Consultant Nephrologist at Sagar Hospitals, Bengaluru, has spent more than two decades working against that silence. He pushes for early detection with two simple annual tests. He guides patients through the process of dialysis and transplantation. And he treats the conversation with the patient and family as an important part of the treatment itself. That combination of clinical depth across transplant care, dialysis and other kidney diseases, a public-health instinct for prevention, and the patience to give every patient and family the time they need is why he features among India’s Top Nephrologists of 2026.
A Puzzle Worth Solving
Dr. Sanjeev Kumar Hiremath describes medicine as a mix of curiosity and the urge to solve medical problems. His role models were his parents, his father a teacher and his mother a homemaker, and his mentor, Dr. Shivashankar, his professor at M.R. Medical College, Gulbarga, where he completed his MBBS and his MD in 1995. He then secured his nephrology seat at KEM Hospital on merit and trained under pioneers of the specialty, from Seth G.S. Medical College and KEM Hospital, Mumbai. In 1996, his paper “Adequacy of Dialysis” won the Best Paper Award at the Indian Society of Nephrology (ISN) West Zone Conference in Pune, and was later accepted at the 42nd Annual Congress of the Japanese Society for Dialysis Therapy in Sapporo, Japan.
Nephrology was a deliberate challenge. Many of his role models were cardiologists, and nephrologists were very few. “I thought, let me challenge this subject of nephrology,” he says. He also comes from a modest background, and the sight of patients with diabetes and hypertension, along with the irrational use of painkillers, in villages and cities alike, sliding towards chronic kidney disease reinforced his choice.
In the years since, his work has spanned complex renal diseases across nephrology and transplant immunotherapy, alongside teaching at academic institutions and contributing to research papers. He served as the first co-convener of the Nephrology Association of Karnataka (NAK) and is an active member of several nephrology societies. His honours include the Legendary Award from the Times of India (2019) for clinical excellence and long service to the medical fraternity, recognition from the NAK and ISNSC (2020) for his contributions to the field, and the Silver Jubilee Legend Award (2026), marking 34 years of service in nephrology. These accolades, he says, keep him motivated to contribute more to the field and to guide younger nephrologists.
Two Patients Who Made the Choice Permanent
Two cases, he says, stayed with him. The first was a girl in the 10th standard who spent a year on dialysis. “She told me, Doc, I want to be a nephrologist like you,” he recalls. His reply was to tell her to become a good person first. He later performed her transplant, with her mother as the donor. She went on to complete her postgraduate studies and now works in a company.
The second was a transplant using the kidneys of a very young donor, a child of around 28 months, whose parents chose to donate. The kidneys were tiny, perhaps five to six centimetres. Within about three months, they had grown to adult size. “I was fascinated by what nature can do to a small kidney so that it sustains the life of an adult,” he says. “It impressed on me that nature adapts to any body, of any age, and that we should always keep nature and the body in good shape.”
Counselling as Clinical Practice
Dr. Sanjeev is emphatic that a correct diagnosis is worth little if the patient does not understand it. “Even if you have made an excellent diagnosis, if you don’t know how to convince the patient, it’s of no use,” he says. He spends 30 to 45 minutes counselling patients before starting dialysis or beginning the transplant process, and the donor and the whole family are counselled about the transplant just as carefully and judiciously. When asked to choose between donor and recipient, his answer is unhesitating: “Our priority as nephrologists is always the donor.” He sees explaining a complex illness to a patient in simple terms, in their own language, as an art, one that comes only from years of practice, compassion and dedication, and never from a textbook, YouTube or AI.
Care That Fits the Patient
He arrived in Bengaluru in 1999 and began private practice in 2000, outside the corporate hospital system, which by his account made him the second nephrologist in the city to do so. His reasoning was practical: in a private clinic, he could understand each patient’s financial situation and logistics, and tailor care to what they could access and afford. His concept is simple: to do the best for his patients. Today, his day begins with exercise and prayers to the Almighty, followed by rounds at Sagar Hospitals and Prashanth Hospitals, among others. He describes hospital work as absolutely pure teamwork. “No one can say I am the boss,” he says.
A Message for Every Household
His most practical message is aimed at the general public, in the city and in the villages. He recommends two simple tests, serum creatinine and urine protein-creatinine ratio, done every year from the age of 18, and believes awareness of them should be part of the higher primary school syllabus. People with diabetes should repeat them every six months. His reasoning is blunt: kidney damage, once done, does not return to normal and always progresses to end-stage disease. His recommendation is to respect your kidneys as you respect any other part of your body.
His dietary advice is equally direct. He recommends keeping salt intake to a minimum, with a little more for those who sweat heavily in humid conditions. He advises a largely vegetarian, low-protein diet, adequate water intake, and close attention to potassium for anyone with kidney disease. He adds a warning: “Please do not copy another patient’s treatment, and do not follow another patient’s advice, as all of them are sailing in the same boat.”
A Doctor for the Community
His commitment to the public extends well beyond the consultation room. Every year on World Kidney Day, he organises celebrations that honour dialysis patients and their families, along with the doctors on his team and people who have made a contribution to society. He also provides nephrology care to old age homes that need it, and looks after the teachers, support staff and technical staff of a private school in South Bengaluru.
Technology, With Caution
Dr. Sanjeev Kumar Hiremath believes adopting new technology is part of a doctor’s job, and he always embraces newer technologies for better patient care. He is very optimistic about AI, but feels that general intelligence is always better than artificial intelligence. He is equally clear about AI’s limits. It may offer a hundred possible diagnoses, he says, but choosing the right one for the patient is the doctor’s own judgement. He flags data security and the training gap between developers and clinicians as concerns. His suggestions include teaching doctors AI in small, digestible capsules, regularly upgrading practical apps, encouraging daily use, and making sure the technology doesn’t confuse people.
Life Outside the Hospital
Dr. Sanjeev Kumar Hiremath is candid that work-life balance in medicine is “almost impossible,” and that the hospital becomes a second home. He still works close to twelve hours a day, protecting his exercise and six to seven hours of sleep. He is married to Dr. Namrata, an onco-pathologist, and together they have two children. Their daughter, Dr. Srushti S Hiremath, is pursuing her PG in General Medicine, while their son, Saharsh S Hiremath, has chosen a career in animation rather than medicine. He looks forward to taking care of his parents in their old age. He is a keen follower of sports, especially hockey, cricket and athletics, and played hockey himself, representing Gulbarga University at the all-India inter-university level across several seasons and Karnataka at the national level in Ranchi.
His advice to aspiring nephrologists is simple and unsentimental. “You have to be dedicated, passionate and empathetic, and you have to spend time with the patient and the family,” he says. If financial gain is the motive, he suggests, look elsewhere. Passion is the only reason to choose the field, because it is tiring and sometimes unrewarding. He measures the future the same way he measures his days: “Every day is a learning curve, a new surprise. I have to think out of the box so that I can give brightness back to the person sitting in front of me.”
