More than 844 million adults around the world live with chronic kidney disease (CKD), though the majority remain unaware of their condition. Kidneys gradually deteriorate without obvious warning signs until significant harm has already occurred. A recent series published in The Lancet examines the growing prevalence of CKD and explains how routine screenings could detect the disease much earlier.
The disease develops when kidneys gradually lose their ability to filter blood properly. Global estimates place the number of affected adults between 788 million and 844 million, and projections indicate CKD will rank as the fifth-leading cause of death by 2040. However, in wealthier nations, 30 to 50% of cases remain unidentified, with some areas experiencing even higher rates of undiagnosed illness.
This oversight arises because early-stage CKD often produces no symptoms. Individuals may feel entirely healthy while their kidney function steadily declines over time.
Two standard tests could address this gap. The first measures the estimated glomerular filtration rate (eGFR), derived from a blood test that assesses creatinine levels. This value indicates how efficiently kidneys filter blood, and many people already receive it during regular checkups.
The second test evaluates the urine albumin-to-creatinine ratio (uACR), which detects albumin—a protein that appears in urine when kidney damage occurs. Unlike the eGFR, this test is frequently omitted from standard health panels, despite its importance. A person might show normal eGFR results while still experiencing early kidney deterioration, as indicated by raised albumin levels.
How lifestyle and health risks fuel CKD
Combining both measurements provides a more complete assessment. The series identifies diabetes, hypertension, obesity, cardiovascular disease, genetic predisposition, and aging as key risk factors for CKD. These same factors influence overall health, making blood pressure control, blood sugar management, and dietary habits essential for kidney protection.
Kidney function is closely linked to cardiovascular and metabolic health. Persistent high blood pressure damages kidney blood vessels, while prolonged raised blood sugar impairs their filtering capabilities. Lifestyle choices that promote longevity—such as regular physical activity, avoiding tobacco, and maintaining a balanced diet—also help sustain kidney health.
Detecting CKD does not demand specialized procedures. The eGFR and uACR deliver clear, actionable information before symptoms emerge. For the millions living with undiagnosed CKD, these two tests could mean the difference between timely treatment and years of delayed care.
Public awareness remains the primary obstacle. With 844 million adults affected, the concern shifts from whether kidney health is important to why so few individuals know their own kidney function status.
Experts emphasize that the tools for early detection already exist. The challenge lies in ensuring these tests become part of standard medical evaluations. Without broader recognition of CKD’s silent progression, the disease will continue to advance unnoticed in millions of people.
Barriers to early detection and solutions
Healthcare providers must prioritize these screenings, particularly for those at higher risk. Early intervention through regular testing could prevent severe complications and improve long-term outcomes for patients.
Governments and medical organizations should expand access to kidney function testing, especially in regions where awareness is lowest. Public campaigns could highlight the importance of monitoring kidney health as part of general wellness.
Researchers also stress the need for better integration of kidney health into primary care. Many patients receive eGFR results without understanding their significance or the need for follow-up uACR testing. Clear communication from doctors about these numbers could save lives.
Beyond individual actions, systemic changes are necessary. Insurance policies should cover routine kidney screenings without additional costs, and healthcare guidelines must standardize these tests for at-risk populations.
By addressing these barriers, the global burden of CKD could be significantly reduced. The tools are available, what is missing is the commitment to use them.