As World Kidney Day is observed on March 12, medical organizations and specialists are urging increased efforts to detect chronic kidney disease early. This often-silent condition affects millions worldwide, and in Colombia, over one million people are currently living with the disease, many unaware of their diagnosis.
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The warning comes from the Colombian Association of Nephrology and Hypertension (ASOCOLNEF) and Bayer, who emphasized the need for stronger prevention and early diagnosis of Diabetic Kidney Disease (DKD). DKD is a leading complication of diabetes and a frequent cause of kidney failure. Early detection is crucial for managing chronic conditions and improving patient outcomes.
Nephrologists are calling for wider use of early testing to slow the progression to kidney failure. Photo:iStock
Globally, approximately 850 million people – around 10% of the world’s population – are estimated to have chronic kidney disease (CKD), according to data cited by the organizations. In 2023, CKD was the ninth leading cause of death worldwide, affecting 14% of adults over the age of 20.
The situation is particularly concerning when considering the effects of kidney disease linked to diabetes. Studies show that when diabetes begins to affect kidney function, a patient’s life expectancy can be reduced by as much as 16 years if left untreated.
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“It’s essential to understand that the heart and kidneys work as an interconnected system. when one fails, the other suffers,” explained Dr. Silvia Rey, Bayer’s medical advisor for cardio-renal issues. She noted that DKD shouldn’t be viewed as an isolated complication, but as a factor that accelerates cardiovascular risk.
Dr. Rey stated that medical approaches should go beyond glucose control and focus on strategies that protect both organs simultaneously. “Our focus must extend beyond glucose control, integrating therapies that protect both the heart and kidneys at the same time to slow inflammation and structural damage before it becomes irreversible,” she said.
A Disease That Progresses Without Symptoms
One of the biggest challenges with chronic kidney disease is its silent nature. In its early stages, the condition often progresses without noticeable symptoms, making early diagnosis difficult.
Scientific evidence indicates that the progression of DKD is closely linked to metabolic and inflammatory factors that worsen over time. Diabetes plays a central role: approximately 40% of people living with diabetes develop some degree of kidney damage.
Prolonged high blood sugar levels can progressively impair kidney function, even before symptoms appear.
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In addition to diabetes, other factors increase the risk of chronic kidney disease, including high blood pressure and being overweight or obese. Unhealthy lifestyle choices and the presence of protein in the urine, an early indicator of kidney damage, also contribute.
Most patients are diagnosed when the disease is already advanced. Photo:iStock
In some patients, the first detectable sign is increased protein in the urine, known as albuminuria. In others, deterioration is evident through a significant decrease in the glomerular filtration rate, a key measure of the kidneys’ ability to filter waste.
A Growing Problem in Colombia
The challenge is also significant in Colombia. According to the most recent High-Cost Account report, published in 2024, more than one million Colombians live with chronic kidney disease.
However, this number may only represent part of the problem due to the disease’s asymptomatic nature in its early phases. Many patients are diagnosed only when the condition has progressed to critical and irreversible stages.
This situation is concerning for the healthcare system, as many patients enter nephroprotection programs in late stages, when therapeutic options are more complex and expensive.
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These alternatives include treatments such as dialysis or kidney transplantation, procedures typically required when kidney damage is advanced.
The risk is intensified considering the prevalence of diabetes in the country. Currently, nearly two million Colombians live with diabetes, making Diabetic Kidney Disease the most common microvascular complication and a leading cause of kidney failure.
In Colombia, more than one million people live with chronic kidney disease, many without knowing it. Photo:iStock
“The biggest challenge in Colombia is to detect the disease before the patient needs a dialysis machine,” said Dr. Juan Diego Montejo, president of ASOCOLNEF.
The specialist emphasized that one key strategy is to expand the use of simple tests to identify kidney damage in its early stages. “We need to scale up tests such as albuminuria measurement at all levels of care,” he said.
The Challenge of Expanding Diagnostic Testing
Albuminuria measurement is considered one of the most sensitive markers for early detection of kidney damage and predicting the progression of cardiorenal disease. This test can identify alterations even before the glomerular filtration rate begins to decline.
Despite its importance, only four out of ten patients in Colombia have this measurement, indicating underutilization of this diagnostic tool.
Experts say this gap can delay key therapeutic decisions and limit opportunities to prevent progressive kidney deterioration.
The impact of diabetic kidney disease extends beyond the clinical realm, also imposing a significant economic burden on the healthcare system.
The cost associated with this disease is estimated at 428 million pesos per 1,000 patients, primarily due to cardiovascular hospitalizations and treatments such as dialysis.
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At the individual level, the consequences are also profound. The disease can reduce more than 10 years of quality-adjusted life, due to the impact of premature death and associated complications.
Faced with this situation, specialists insist that Colombia’s goal should be to transform the current model towards an early nephroprotection strategy. Detecting the disease in its early stages would not only improve patients’ quality of life but also reduce the burden on the healthcare system.
EDWIN CAICEDO
Environmental and Health Journalist
@CaicedoUcros
