Chronic kidney disease (CKD) has joined the world’s top ten causes of death for the first time, underscoring a growing global health crisis that experts warn is silently affecting millions of adults, including in Kenya.
A new analysis published in The Lancet estimates that more than 800 million adults — roughly one in ten globally — are living with CKD, a long-term condition where the kidneys gradually lose their ability to filter waste and fluids from the blood.
The study found that CKD was responsible for 1.48 million deaths in 2023, ranking ninth worldwide — ahead of tuberculosis and colorectal cancer, and just behind liver disease. Only heart disease, stroke, and diabetes claimed more lives.
“CKD is often called a silent killer because most people don’t know they have it until it’s too late,” the study noted, emphasizing the need for early screening among high-risk groups such as people with diabetes, high blood pressure, or a family history of kidney problems.
A Rising Burden
Globally, the age-standardised mortality rate for CKD increased from 24.9 per 100,000 in 1990 to 26.5 in 2023 — even as deaths from many other major diseases have declined.
The report identifies high blood sugar, hypertension, and obesity as leading contributors, alongside poor diets high in sodium and low in fruits.
Beyond its direct toll, CKD is also a major driver of cardiovascular deaths, linked to 11.5 per cent of all heart-related fatalities worldwide.
The Kenyan Picture
In Kenya, CKD has become a growing public health concern. The Kenya Renal Association estimates that about four million Kenyans are living with some form of kidney disease — a number projected to rise to 4.8 million by 2030.
A 2022 study put Kenya’s CKD prevalence at around 4 per cent, slightly below the sub-Saharan African average.
However, treatment remains costly and often inaccessible, especially outside major cities.
Dialysis sessions, which patients with advanced CKD require multiple times weekly, can cost thousands of shillings per visit, putting them beyond the reach of many.
Silent Symptoms, High Risks
Because early-stage CKD often shows no clear symptoms, many patients are diagnosed late, when kidney function is already severely compromised.
Typical signs at advanced stages include fatigue, swelling, changes in urination, persistent itching, muscle cramps, and breathlessness.
Age, diabetes, hypertension, and HIV infection are the biggest risk factors, but lifestyle choices — such as smoking, excessive alcohol use, and the use of certain herbal remedies — also increase vulnerability.
Health experts warn that Kenya must integrate CKD screening and prevention into national health strategies focused on non-communicable diseases like diabetes, hypertension, and obesity.
“The evidence is clear — CKD is both a cause and a consequence of other chronic conditions,” the Lancet study concluded. “Without preventive action and early diagnosis, the disease burden will continue to grow, particularly in low- and middle-income countries.”
Efforts to promote routine kidney function testing, healthier diets, and improved access to dialysis and transplant services could significantly reduce CKD-related deaths in Kenya and beyond.