Early Kidney Disease Detection: Colombia Faces Rising Cases & Silent Threat

The clock is ticking for millions living with chronic kidney disease (CKD). As marked by World Kidney Day on March 12th, medical specialists and organizations are urgently reinforcing the need for early detection of this often-silent condition. Globally, an estimated 850 million people – roughly 10% of the world’s population – are affected by CKD and in Colombia alone, over one million individuals are currently living with the disease, many undiagnosed.

The call to action comes from the Colombian Association of Nephrology and Hypertension (ASOCOLNEF) and Bayer, who are specifically highlighting the importance of early diagnosis and prevention of Diabetic Kidney Disease (DKD), a leading complication of diabetes and a frequent cause of kidney failure. The Cuenta de Alto Costo (CAC) reports that as of December 31, 2023, 1,014,594 preliminary cases of CKD were reported in Colombia.

The Silent Threat: Why Early Detection Matters

One of the most significant challenges with CKD is its insidious nature. In its initial stages, the disease often progresses without noticeable symptoms, making early detection difficult. This delay can have devastating consequences. Studies show that when diabetes begins to impact kidney function, a patient’s life expectancy can be reduced by as much as 16 years if intervention doesn’t occur promptly.

Dr. Silvia Rey, Bayer’s cardio-renal medical advisor, emphasizes the interconnectedness of heart and kidney health. “It’s fundamental to understand that the heart and kidneys function as an interconnected system; when one fails, the other suffers,” she explains. DKD shouldn’t be viewed as an isolated complication, but rather as a factor that accelerates cardiovascular risk. A comprehensive approach to treatment, protecting both organs simultaneously, is crucial.

Beyond Glucose Control: A Holistic Approach

Traditionally, managing diabetes has focused heavily on glucose control. However, experts now advocate for a broader strategy that actively protects both the heart and kidneys. Dr. Rey advocates for therapies that go beyond glucose management, aiming to reduce inflammation and structural damage before it becomes irreversible. This approach recognizes that DKD is not simply a consequence of high blood sugar, but a complex process involving metabolic and inflammatory factors.

Risk Factors and Prevalence

Even as diabetes is a major driver of CKD, it’s not the only risk factor. Hypertension (high blood pressure) and obesity also significantly increase a person’s susceptibility. Unhealthy lifestyle choices and the presence of protein in the urine (albuminuria) are also early indicators of potential kidney damage.

Globally, CKD was the ninth leading cause of death in 2023, affecting 14% of adults over the age of 20. In Colombia, the situation is particularly concerning, with many patients entering nephroprotection programs only in advanced stages of the disease, when treatment options are more complex and costly. ASOCOLNEF recently celebrated World Kidney Day on March 12th, emphasizing the importance of kidney care.

The Challenge of Diagnosis in Colombia

The CAC’s 2024 report reveals that over one million Colombians are living with CKD. However, this number is likely an underestimate due to the disease’s asymptomatic nature in its early phases. Many patients remain undiagnosed until the condition has progressed to a critical, and often irreversible, stage. This late diagnosis places a significant strain on the healthcare system, as patients require more intensive and expensive treatments like dialysis or kidney transplantation.

According to Dr. Juan Diego Montejo, president of ASOCOLNEF, “The great challenge in Colombia is to detect the disease before the patient needs a dialysis machine.” He stresses the need to expand the use of simple tests, such as albuminuria measurement, at all levels of healthcare.

Albuminuria: A Key Early Indicator

Albuminuria, the presence of protein in the urine, is a sensitive marker for early kidney damage. It can often be detected even before glomerular filtration rate (GFR) – a measure of kidney function – begins to decline. Despite its importance, only four out of ten patients in Colombia currently undergo albuminuria testing, indicating a significant gap in diagnostic practices.

What’s Next: Improving Early Detection and Prevention

Addressing this gap requires a shift towards a proactive nephroprotection strategy. Early detection not only improves patient quality of life but also reduces the economic burden on the healthcare system. Expanding access to albuminuria testing is a crucial first step.

The focus must also extend to broader public health initiatives promoting healthy lifestyles, including regular check-ups, blood pressure control, and diabetes management. Further research is needed to identify individuals at high risk and develop targeted prevention programs. Federación Colombiana de Enfermedades Raras recently shared information about World Kidney Day on Instagram, highlighting the importance of awareness.

a collaborative effort involving healthcare providers, policymakers, and the public is essential to combat the growing threat of chronic kidney disease and ensure equitable access to care for all.