La chronic kidney disease (CKD) It is advancing silently and is already among the world's greatest health challenges. A comprehensive international analysis published in The Lancet details that cases have more than doubled since 1990, reaching almost almost 800 million peopleand that in 2023 around [number missing] were attributed to this pathology 1,5 million deaths.
In addition to its direct impact, CKD multiplies other health risks: kidney dysfunction is closely associated with cardiovascular disease and worsens its prognosis. According to the study, approximately 14% of adults They live with some degree of kidney impairment, a problem that is often underdiagnosed and which the WHO has placed among its objectives for reducing premature mortality.
Global magnitude and trends
The work of the Global Burden of Disease (GBD) 2023 consortium, led by teams from IHME (University of Washington), NYU Langone and the University of Glasgow, estimates a jump of 378 million cases in 1990 to 788 million in 2023CKD was the ninth leading cause of death and the twelfth leading cause of disability, with a age-standardized mortality which continues to rise (from 24,9 to 26,5 per 100.000). Furthermore, kidney dysfunction is behind nearly all of the cases. 12% of cardiovascular deaths.
The load is especially heavy in China and India (between 152 and 138 million people with CKD), and exceeds 10 million per country in territories such as the United States, Indonesia, Japan, Brazil, Russia, or Mexico. In Europe, population aging and the increase in diabetes and hypertension They maintain an upward trend that worries specialists and public health officials.
Risk factors and their link to the heart
The research identifies 14 risk factorsHyperglycemia (diabetes), hypertension, and obesity are the leading causes of health loss. Dietary habits, such as [the following], also play a significant role. high sodium intake and insufficient intake of fruits and vegetables, and other risks, such as Mistakes that promote urinary tract infectionswhich contribute to kidney damage in the medium and long term.
The link with the cardiovascular system is bidirectional: CKD worsens the cardiac prognosis, and cardiac damage accelerates renal deterioration. In its initial stages, it often goes unnoticed, hence the importance of a basic screening with creatinine and albumin in urine (albuminuria), simple markers that allow early detection of high-risk patients.
Spain: prevalence, dialysis and transplantation
In our country, nephrologists warn that CKD affects around 10–15% of the adult population...with a large backlog of undiagnosed cases. More than 68.000 people They require dialysis or a transplant to continue living, which reflects the strong healthcare and social impact of the disease.
Although the prevalence is growing, the incidence of new renal replacement therapy It has stabilized at around 150,1 patients per million population. In absolute terms, it is estimated that approximately 7.300 people They started dialysis or recently received a transplant, figures that encourage strengthening early diagnosis and control of risk factors.
Screening and campaigns underway
The Spanish Society of Laboratory Medicine promotes awareness-raising actions such as "Valencia takes care of your kidneys"with rapid creatinine determinations from a drop of capillary blood to make screening more accessible to the public. The initiative is being carried out in collaboration with ALCER, the SEN and the SEMG, with technical support from Nova Biomedical and support from pharmaceutical companies, with a focus on education and public health.
On a daily basis, the clinical laboratory facilitates two essential tests available in Primary Care: the creatinine with estimated glomerular filtration rate and the albumin/creatinine ratio in urine. Its systematic use in at-risk populations (diabetes, hypertension, obesity, advanced age) may change trajectory of the disease and optimize the resources of the health system.
Treatments and therapeutic advances
In recent years, drugs have become available that help to slow down the progression of CKD and reduce cardiovascular events, such as SGLT2 inhibitors, within an approach that includes blood pressure control, glycemic management, and lifestyle changes. Coordination between Primary Care and Nephrology It is key to adjusting the therapy to the cause and the stage.
However, they persist, inequalities of accessIn low- and middle-income regions, dialysis and transplantation remain less accessible due to economic and logistical barriers. This gap makes it difficult for advances to translate uniformly into better outcomes globally.
Aging, symptoms and treatment safety
In old age, CKD is common and mild symptoms Initially. As it progresses, swelling may appear in the legs, along with changes in color. ammonia smell in urine or increased urination and marked fatigue. These signs warrant a consultation and simple blood tests to confirm the diagnosis and plan follow-up.
La polypharmacy This necessitates extreme caution: nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and some antibiotics can damage the kidneys, and many medications require dose adjustments based on glomerular filtration rate (GFR). Regular medication reviews prevent interactions and reduce adverse events.
With a combination of prevention, accessible screeningWith rigorous control of diabetes and hypertension and therapies that slow progression, CKD can be addressed more effectively: global data and experience in Spain suggest that strengthening early detection saves lives and reduces the need for replacement therapies in advanced stages.