The number of chronic kidney disease patients worldwide is rapidly increasing! 800 million people face the silent risk — the correlation between diabetes, hypertension, obesity, and kidneys

Preface—The "Quietly Progressing" Global Disease

Chronic kidney disease (CKD) progresses easily due to its lack of noticeable symptoms, eventually requiring dialysis or transplantation at the end stage. According to the latest international estimates, CKD affects 788 million people worldwide and ranked 9th in the cause of death in 2023. Moreover, kidney dysfunction is involved in **about 12%** of cardiovascular deaths. These figures indicate that CKD has emerged as a central global health issue, contrary to its invisibility.ZDFheute

What Has Driven the Increase?

The estimated number has doubled from 378 million in 1990 to 2023. Major drivers include population aging and the global increase in diabetes, hypertension, and obesity. These conditions chronically burden the renal glomeruli, gradually impairing kidney function over many years. This estimate is based on a model integrating data from 204 countries and regions, and over 2,200 data sources. The research team, led by Theo Vos from the University of Washington, published their findings in 'The Lancet.'fehmarn24.de

Regional Differences—High-Rate Areas and Exceptions

The global average prevalence rate is about 14%. Notably, **North Africa and the Middle East have about 18%**, and regions like South Asia, Sub-Saharan Africa, and Latin America also exceed the average. In contrast, Germany has 8.4%, with reports indicating a declining trend since 1990. CKD is not uncommon even in high-income countries—countries like Japan, where longevity and lifestyle diseases are prevalent, require more innovative measures to prevent oversight.fehmarn24.de

"Quiet in the Early Stages"—That's Why Urinalysis is Effective

CKD has few noticeable symptoms in the early stages (Stages 1-3). It is widely known that a single urinalysis (albuminuria) and blood test for eGFR can screen for it. Those with diabetes, hypertension, obesity, family history, smokers, and the elderly should be particularly cautious. Early detection provides significant potential for slowing progression.The Times of India

Current Status of Progression Inhibition—Lifestyle and Pharmacotherapy

In addition to managing salt, protein, weight, smoking, sleep, and exercise, ACE inhibitors/ARBs are standard for kidney protection. Recently, the effectiveness of SGLT2 inhibitors has been established, with reports of CKD progression inhibition regardless of diabetes presence. Optimizing such treatments can reduce the risk of transitioning to end-stage renal failure and decrease cardiovascular events (※ Consult with your primary care physician for treatment options). If both policy and clinical practice are aligned, it may relatively reduce reliance on transplantation.ZDFheute

Signs of Hope—Increase in Transplants

In the worst-case scenario, kidney transplantation is necessary, but the number of transplants increased from about 1.59 million in 1990 to about 4.59 million in 2023. This reflects advances in medical technology and system development. However, transplantation faces structural constraints like donor shortages and significant regional disparities. A comprehensive strategy of primary prevention, secondary prevention (early detection), and tertiary prevention (progression inhibition) is essential.fehmarn24.de

Challenges and Opportunities in Japan

In aging Japan, the burden of CKD, exemplified by diabetic nephropathy, is significant. The prevalence of urine albumin tests in health checkups, outcomes of lifestyle disease management, and patient education systems—there is much room for improvement. Conversely, if **"urinalysis × health guidance × optimization of pharmacotherapy"** can be thoroughly implemented, Japan could become a leading model for the world.

Media Reports on the "Crisis" and "Solutions"

German news points out that "CKD lacks policy attention despite effective drugs being available." Medical journal editorials repeatedly warn about regional prevalence differences and weak healthcare systems. How to connect the weight of the reported 9th leading cause of death and 1.48 million deaths to testing behavior and improved healthcare access—this is the challenge.fehmarn24.de

Self-Check and Actions You Can Take Now

• If you haven't had a urinalysis (albumin) and eGFR in the past year, make an appointment.

• Make it a habit to manage blood pressure, blood sugar, and weight at home. Do not stop antihypertensive or diabetes medications on your own.

• Aim for less than 6g of salt per day (be cautious of eating out and processed foods).

• Engage in moderate aerobic exercise, like brisk walking, for 150 minutes per week.

• Smoking damages kidney blood vessels. Utilize smoking cessation support.
  (※ For individual advice, consult your primary care physician)
  
  
  

Conclusion—Take the Initiative Because It's "Quiet"

CKD progresses quietly. However, testing is simple, and there are measures to inhibit progression. By expanding screening at the national and local government levels, optimizing treatment by healthcare providers, and reviewing our individual lifestyles, we can certainly reduce the number of people requiring dialysis or transplantation. Let's tackle the era of 800 million people with action.ZDFheute