Nearly half of 844 million chronic kidney disease cases remain undiagnosed worldwide: Lancet

An estimated 30% to 50% of chronic kidney disease (CKD) cases remain undiagnosed even in high-income countries, with the proportion likely to be much higher in low- and middle-income nations, according to a new series of papers published in The Lancet. Researchers have urged wider use of simple urine tests to improve early diagnosis and treatment of a disease that affects 844 million adults worldwide.

Disease burden

Chronic kidney disease, a progressive condition in which the kidneys gradually lose their ability to function, is currently the ninth leading cause of death globally and is projected to become the fifth by 2040, the papers said.

The researchers noted that CKD often progresses silently, with most people experiencing few or no symptoms until the disease reaches an advanced stage, when dialysis or a kidney transplant may be required. This contributes to low diagnosis rates and delays in treatment.

The series, led by researchers from the University of Glasgow, said routine urine testing for protein, along with blood tests measuring kidney function and blood pressure checks, could help detect the disease much earlier. Early diagnosis allows timely treatment that can slow or even prevent progression of kidney disease.

The papers also highlighted disparities in diagnosis, noting that women and people from non-white ethnic groups are more likely to remain undiagnosed. Even among those whose medical records indicate CKD, many are unaware they have the condition.

Researchers said diabetes, hypertension, obesity and cardiovascular disease are among the leading risk factors for CKD, while the risk also increases with age.

Better screening

The authors called for greater investment in kidney disease screening, laboratory capacity and healthcare systems, particularly in low- and middle-income countries where access to diagnostic services remains limited.

The series also reviewed advances in kidney disease research, including improved biomarkers, genetic testing and newer therapies that can delay disease progression when treatment is started early.