Chronic kidney disease (CKD) is often called ‘silent killer’ as most people live with it for years without symptoms. In resource-limited settings, up to 9 out of 10 individuals with CKD are unaware of their condition, delaying crucial interventions.1 Despite being a growing global health crisis, kidney disease remains widely misunderstood and under-communicated, leading to severe health and economic consequences. Kidney Awareness Month serves as a critical opportunity to amplify education and encourage early detection.
A Growing Global Crisis
CKD affects approximately 850 million people worldwide and is the third fastest-growing cause of death. By 2040, it is projected to become the fifth leading cause of premature mortality.1 Modern lifestyle diseases—such as diabetes and hypertension significantly contribute to this burden, with 1 in 3 adults and 1 in 5 adults at risk of developing this disease, respectively.2
Additionally, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) poses a growing threat. Around 30 million people globally consume NSAIDs daily,3 and unmonitored long-term use can worsen kidney function, further increasing CKD prevalence.
The Economic Toll of CKD
Beyond health risks, CKD imposes a profound economic burden. By 2027, the direct annual costs of diagnosed CKD and kidney replacement therapy (KRT) are expected to reach $406.7 billion.4
The challenge is particularly severe in low- and middle-income countries, where about 78% of patients with CKD reside, and health systems struggle with limited resources and systemic inequalities.5 The financial burden frequently falls on families, leading to catastrophic health expenditures. Patients often lose their ability to work, further impacting household income and national productivity.
Unawareness and the Problem of Late Diagnosis
More than 90% of people with early-stage CKD are unaware of their condition.1 The disease progresses silently, often overlooked until symptoms appear increasing risk for serious health complications such as heart attack, stroke, and kidney failure. Understanding the stages of kidney disease is crucial in recognizing progression and taking necessary preventive measures. Early detection through screening and risk stratification could significantly reduce morbidity and mortality. However, at present, there is no accepted systematic strategy for CKD screening and treatment.
For example, in the United States, over 20% of individuals with hypertension have increased albuminuria, yet only 7% have tested for it.6 Delayed diagnoses also raises treatment cost by 19% compared to early detection.7 Additionally, Late-stage CKD often requires dialysis or transplants, both costly and with limited accessibility.
In contrast, early-stage CKD can often be managed effectively through medication, lifestyle changes, and controlling underlying conditions like diabetes and hypertension. But this is only possible when the disease is identified in time.
Treatment Affordability and Accessibility
Kidney disease is not just a health issue—it’s a socioeconomic challenge. In many countries, dialysis centres are concentrated in urban areas, leaving rural populations underserved. Even when available, treatment is expensive, with annual costs reaching $19,380 for dialysis and up to $26,903 for the first year of a kidney transplant.8 Many patients delay or forgo treatment due to financial constraints, worsening outcomes.
Strengthening Awareness, Early detection, and Communication
Kidney Awareness Month is a key initiative that seeks to promote education, encourage early screening, and advocate for health policies that support kidney patients. World Kidney Day, led by the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF), also aims to enhance kidney health education and drive policy changes.
Incorporating CKD screening into public health initiatives enhances cost efficiency and resource utilization. Successful examples include Thailand’s Screening and Early Evaluation of Kidney Disease program and South Africa’s HIV Treatment Program, which has integrated serum creatinine testing to monitor kidney function.5
Digital and mobile platforms offer scalable CKD screening solutions. In rural India, telehealth programs and point-of-care (POC) testing for creatinine and urine albumin have improved risk assessment and diagnostic accuracy at the primary care level.5
Public health messaging should emphasize kidney health through lifestyle choices—nutrition, hydration, exercise, and routine screening. Stronger communication strategies, including public education campaigns, HCP engagement, social media outreach, and community initiatives, are crucial, especially for underserved groups. Addressing the emotional and social aspects of CKD can empower patients, reduce stigma, and encourage timely care-seeking.
Conclusion: Early Action Saves Lives
Kidney disease is a growing global health threat, but it is also one that can be detected early, managed effectively, and even prevented—provided the right information reaches the right people at the right time.
Enhancing communication about kidney disease is not just a public health priority but a moral responsibility. With better education, awareness, and timely intervention, we can help millions avoid the severe consequences of this silent epidemic.
References:
Francis A, Harhay MN, Ong ACM, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol. 2024;20(7):473-485.
Preventing Chronic Kidney Disease. Available at: https://www.cdc.gov/kidney-disease/prevention/index.html#:~:text=Manage%20CKD%20risk%20factors,Family%20history%20of%20CKD. Last accessed: March 2025.
Montuori P, Shojaeian SZ, Pennino F, et al. Consumer awareness and knowledge regarding use of non-steroidal anti-inflammatory drugs (NSAIDs) in a metropolitan area. Front Pharmacol. 2024;15:1362632.
Chadban S, Arıcı M, Power A, et al. Projecting the economic burden of chronic kidney disease at the patient level (Inside CKD): a microsimulation modelling study. EClinicalMedicine. 2024;72:102615.
Wijewickrama E and Kalyesubula R. World Kidney Day: Detecting Kidney Disease in Low- and Middle-Income Countries. Kidney Int Rep. 2025;10:637–640.
Shlipak MG, Tummalapalli SL, Boulware LE, et al. The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2021;99(1):34-47.
Spencer D, Dunning S, McPheeters J, St Clair Russell J, Hane C. Health care costs associated with unrecognized progression to late-stage kidney disease. Am J Manag Care. 2023;29(2):e64-e68.
Bello AK, Okpechi IG, Levin A, et al. An update on the global disparities in kidney disease burden and care across world countries and regions. Lancet Glob Health. 2024;1
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