Global Study Reveals Alarming Surge in Chronic Kidney Disease

• CKD reflects long-term injury to the kidneys’ filtering system — As the filters in your kidneys become damaged, the remaining ones work harder to maintain filtration. This compensatory mechanism keeps you feeling stable even as the underlying decline continues.

Over time, the added workload exhausts the remaining filters and causes a drop in the kidneys’ overall filtration rate. Unlike acute kidney injury, which develops suddenly and may be reversible, CKD progresses gradually over months or years and typically leads to permanent loss of function.⁴

• Clinicians measure this decline through two main markers — The first is the estimated glomerular filtration rate (eGFR), which shows how much blood your kidneys filter each minute. Think of it as a measure of how efficiently your kidneys are cleaning your bloodstream. An eGFR lower than 60 indicates reduced kidney function, while lower than 15 signals kidney failure.

The second is albumin in the urine, measured through the albumin-to-creatinine ratio (ACR). Albumin is a type of protein that should stay in your blood, not leak into your urine. When it shows up there, it means your kidney’s filtration barrier has become too porous, allowing larger molecules to slip through.

Together, eGFR and ACR reveal both how well your kidneys are working and how much structural damage has occurred — information that helps your clinician assess how advanced your condition is and how quickly it may progress.⁵

• Kidney disease progresses through five stages — These stages are based on how much filtering power your kidneys have left:^6,7

• CKD affects more than the kidneys — Reduced filtration alters how your body regulates sodium, potassium, phosphorus, and acid, which can disrupt nerve, muscle, and heart function. It also interferes with hormone systems that control blood pressure, red blood cell production, and bone metabolism. These put you at risk of complications such as anemia, high blood pressure, bone loss, vascular calcification, and heart disease.⁸

• CKD prevalence has more than doubled over the past three decades — In 1990, an estimated 378 million adults were living with chronic kidney disease. By 2023, that figure had risen to 788 million. The study estimates that about 14% of the world’s adult population now has some degree of CKD, making it one of the most common chronic conditions worldwide.

• CKD has now become the ninth leading cause of death worldwide, up from 17th in 1990 — In 2023, chronic kidney disease was responsible for an estimated 1.48 million deaths across the globe. When researchers adjusted for population growth and aging, deaths from CKD had still risen by 6.1% since 1990.

• The study also shows how closely your kidneys are tied to your heart — Researchers evaluated impaired kidney function as a risk factor for cardiovascular disease and analyzed how many cardiovascular deaths are linked to it.

They found that kidney impairment accounts for 11.5% of cardiovascular deaths worldwide, ranking seventh among all environmental, behavioral, and metabolic risk factors. It falls just behind high blood pressure and dietary risks and ahead of high blood sugar and high body mass index (BMI).

• Most affected adults have early-stage disease, not kidney failure — The majority of people captured in this dataset were not on dialysis or awaiting transplant. Globally, the combined prevalence of stages 1 to 3 CKD reached 13.9% in 2023.

Only a small fraction of adults were in stages 4 and 5 or on kidney replacement therapy. This means many people live with measurable kidney damage long before dialysis becomes a possibility, and those early years offer the widest window for clinicians to slow or halt progression.

• Three metabolic risks drive most disability-adjusted life-years (DALYs) lost to CKD — DALYs represent years of life lost to early death with years lived in poor health. High fasting plasma glucose accounted for about 32% of CKD DALYs, high systolic blood pressure for about 25%, and high BMI for about 24%.

Diet quality, physical inactivity, exposure to extreme temperatures, and lead stored in bone also contributed to the burden, but elevated blood sugar, blood pressure, and body weight were identified as the biggest risk factor for kidney disease.

• Underdiagnosis blocks early intervention — These risks would be far more manageable if kidney disease were detected and treated earlier, yet underdetection remains a central problem. Albumin in the urine is a simple, powerful marker of kidney damage, but guideline-recommended testing is still uncommon.

Only about 35% of people with diabetes and 4% of those with hypertension undergo albuminuria testing, even in high-income settings. Even when chronic kidney disease is present, about 30% of affected individuals do not have the diagnosis recorded in their medical chart.

• Low-income regions face the steepest burden with the fewest resources — Data on albuminuria and kidney function are sparse in many low-income countries, and access to dialysis and transplant remains extremely limited.

CKD now carries particularly heavy disability and death burdens in regions such as sub-Saharan Africa, North Africa and the Middle East, and Latin America and the Caribbean, even though many people there never reach dialysis.

• Diabetes — Diabetes is the leading cause of CKD worldwide, accounting for approximately 44% of new kidney failure cases.¹⁰ According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about one in three adults with diabetes develops kidney disease.¹¹

When blood sugar remains high for long periods, these vessels gradually thicken and narrow, restricting normal blood flow. As circulation declines, the filters sustain damage, allowing albumin, a protein that normally stays in the bloodstream, to leak into the urine and trigger inflammation that gradually destroys the delicate filtering units.¹²

• High blood pressure — The NIDDK reported that nearly 108 million adults in the U.S. (almost half the population) have high blood pressure, and about one in five of those affected already has some degree of kidney disease.¹³

Elevated pressure inside the small renal vessels gradually injures their walls, leading to scarring that weakens filtration and fuels a self-perpetuating cycle of rising blood pressure and declining kidney function.¹⁴ Learn more in “Did You Know? High Blood Pressure Causes Kidney Damage.”

• Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) — NSAIDs such as ibuprofen and naproxen cause kidney damage by inhibiting prostaglandins, which are essential for maintaining blood flow to the kidneys.¹⁵ Long-term or frequent use of NSAIDs has been linked to faster progression of CKD, especially among older adults.¹⁶

To protect your kidneys, keep medication use to a minimum. Avoid reaching for painkillers or antibiotics as a default, and work with your doctor to explore non-drug options whenever possible.

• Kidney stones — A population-based cohort study published in BMC Nephrology found that 11.2% of individuals with kidney stones developed chronic kidney disease over time, compared to a significantly lower incidence in those without stones.

After adjusting for other risk factors, people with kidney stones were 1.82 times more likely to develop CKD than those without. The researchers concluded that kidney stones are an independent risk factor for CKD, reinforcing the need for regular monitoring and early intervention in patients with a history of stones.¹⁷

• Obesity and metabolic stress — Excess body weight raises both blood pressure and blood sugar, overactivating hormonal and inflammatory pathways that wear down kidney function. Fat tissue also releases pro-inflammatory cytokines that can harm kidney tissue directly.¹⁸

Additionally, obesity causes the kidneys to work harder to filter blood for the larger body mass, leading to glomerular hyperfiltration, a state where individual nephrons become overworked and eventually scarred.¹⁹ Metabolic syndrome, characterized by the combination of abdominal obesity, high blood pressure, elevated blood sugar, and abnormal cholesterol levels, dramatically multiplies kidney disease risk.²⁰

1. Fix your sodium-to-potassium ratio — Maintaining a healthy sodium-to-potassium ratio is essential for regulating blood pressure. However, the goal isn’t to eliminate salt altogether, as cutting salt too aggressively backfires by increasing insulin levels, worsening your cholesterol ratios, and putting your body into a stress state that makes high blood pressure harder to control. The real issue isn’t salt itself but where it comes from.

Most dietary sodium today comes from ultraprocessed food, such as boxed snacks, canned goods, deli meats, and fast food, which are stripped of potassium, a mineral necessary to balance sodium. Replacing these with whole, unprocessed foods such as ripe fruit, root vegetables, and well-cooked leafy greens naturally restores your sodium-potassium balance and supports healthy kidney function.

2. Get your vitamin D levels into the optimal range — Vitamin D plays a central role in regulating the renin-angiotensin system, a hormone network that directly controls blood pressure. When vitamin D levels fall too low, this system becomes overactive, raising blood pressure and increasing strain on the kidneys. The best way to restore balance is through sensible sun exposure.

Make sure you’re getting regular sun exposure, but avoid peak hours (10 a.m. to 4 p.m.) if you consume linoleic acid (LA) from vegetable oils. LA is a polyunsaturated fat that oxidizes easily, builds up in your skin and increases your risk of skin damage.

Cut these oils from your diet for at least six months before getting peak sun exposure. Get your vitamin D levels tested at least twice a year and aim for a level between 60 and 80 ng/mL (150 to 200 nmol/L). If you don’t get regular sunlight, consider supplementing with vitamin D3 to maintain healthy levels year-round.

3. Move more — If you’re already active, aim for about an hour of moderate movement each day, like walking, cycling, or swimming. If you’re just beginning, start small. Even a 10-minute walk after meals helps improve circulation, stabilize blood sugar, and ease pressure on your kidneys. What matters most isn’t intensity, but consistency. Every bit of movement supports healthier kidneys.

4. Limit your oxalate intake — If you’re prone to kidney stones, it would be wise to limit your intake of oxalate. Common high-oxalate foods to watch for include spinach, almonds, peanut butter, sweet potatoes, and figs.

Pairing high-oxalate foods with calcium-rich options helps prevent absorption in the gut. Calcium binds to oxalate, forming a compound that exits the body through your stool instead of your kidneys. Good sources include dairy products and low-oxalate greens like kale.

If you occasionally eat high-oxalate foods, boiling them can help. The heat draws oxalates into the cooking water, which should be discarded. Staying well hydrated is equally important, as drinking plenty of water dilutes oxalates in your urine and reduces the risk of stone formation.

5. Watch your phosphorus intake — Excess phosphorus intake, particularly from processed foods and phosphate additives, forces the kidneys to work harder to filter it from the blood. When kidney function begins to decline, phosphorus can build up, disrupting calcium balance and triggering hormonal changes that further stress the kidneys.²¹

To lower your intake, avoid packaged and processed foods, colas, and fast food meats that often contain added phosphates. Choose fresh, whole foods instead and be sure to read ingredient labels carefully for terms like “phosphate” or “phosphoric acid.” Also, limit dairy if your phosphorus levels are high because dairy products naturally contain large amounts of organic phosphorus easily absorbed by the body.

6. Drink plenty of pure water — Staying well hydrated helps prevent kidney stones by diluting substances in your urine that contribute to stone formation. Let thirst be your guide for how much to drink, but a simple visual cue works just as well. Your urine should be a pale straw or light yellow color. If it turns dark yellow or amber, that’s a clear sign you need more water.

7. Address urinary tract infections (UTI) without antibiotics — In people with CKD, recurring infections have been linked to faster disease progression and a higher likelihood of reaching kidney failure.²² However, many antibiotics used to treat UTI can stress the kidneys. One alternative treatment worth considering is methylene blue. Learn more about it in “Benefits and Side Effects of Methylene Blue — A Comprehensive Guide.”

8. Get regular screening if you have risk factors — If you have high blood pressure, diabetes, or a family history of kidney disease, ask your doctor to include eGFR and urine albumin tests during your regular checkups. These simple screenings can reveal early kidney damage long before symptoms appear, allowing you to take action while the condition is still reversible.