Chronic kidney disease is affecting hundreds of millions of people worldwide, yet many remain unaware they have the condition until it has reached an advanced stage, according to a new series of research papers published in The Lancet.
The research, led by an international team of experts that includes scientists from Adelaide University, highlights concerns that up to half of life threatening chronic kidney disease cases may go undiagnosed. The authors argue that wider use of a simple urine test could help identify the disease earlier and improve patient outcomes.
Chronic kidney disease, commonly known as CKD, occurs when the kidneys gradually lose their ability to function properly over time. The condition currently affects an estimated 844 million adults globally and is expected to become the world’s fifth leading cause of death by 2040.
In Australia, around 2.7 million adults, or about one in seven people, are living with markers of chronic kidney disease. Despite this, awareness remains low, with only 7.4 per cent of affected individuals knowing they have the condition.
One of the challenges facing healthcare providers is that chronic kidney disease often develops without obvious symptoms. People in the early and middle stages may feel well, while symptoms frequently appear only when kidney function has already declined substantially. At that point, some patients may require dialysis or a kidney transplant.
The researchers say this lack of warning signs contributes to poor diagnosis rates and delays in treatment.
The three papers examine the global burden of chronic kidney disease, barriers to diagnosis, and emerging treatment approaches. They also explore differences in diagnosis and treatment between men and women and call for more coordinated prevention and care strategies across healthcare systems.
Lead author Dr Jennifer Lees, Senior Clinical Research Fellow at the University of Glasgow and Honorary Consultant Nephrologist at NHS Greater Glasgow and Clyde, said greater attention was needed to address the growing impact of the disease.
“Chronic kidney disease remains one of the most concerning conditions currently impacting global health,” Dr Lees said.
She said routine urine testing for protein could help improve early diagnosis and treatment, particularly among groups that may be more likely to experience underdiagnosis, including women and non-white populations.
The research points to a simple combination of urine and blood tests, alongside blood pressure monitoring, as an effective way to identify kidney disease before serious complications develop.
Adelaide University researcher Dr Matthew Borg said early detection offered the best chance of slowing disease progression and reducing the risk of kidney failure.
“Kidney disease is often described as a silent condition because many people don’t realise they have it until it has already progressed,” Dr Borg said.
“That’s why simple, low cost tests are so important. They can detect kidney disease early, when treatment is most effective.”
Dr Borg said improving access to routine screening could reduce pressure on health systems while helping people receive treatment sooner.
Chronic kidney disease is linked to a range of other health conditions, including diabetes, high blood pressure, obesity and cardiovascular disease. The risk of developing the disease also increases with age.
The papers note that people living with chronic kidney disease are around two to three times more likely to be hospitalised than those without the condition.
While international health bodies including the United Nations and the World Health Organization have recognised chronic kidney disease as a major public health issue, the researchers argue that efforts to improve diagnosis have not kept pace with the scale of the challenge.
Their findings add to growing calls for earlier screening and broader awareness, with the aim of identifying patients before the disease reaches its most severe stages.
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