Chronic Kidney Disease could become a leading killer by 2040: Here's what researchers found

Kidneys work around the clock. They filter waste, balance fluids, regulate blood pressure, and help maintain healthy bones and blood cells. Yet when kidney function begins to decline, the body often sends very few warning signs.That is one reason chronic kidney disease has become a growing global concern. According to The Lancet's latest CKD Series, an estimated 788–844 million adults worldwide are living with chronic kidney disease, and the condition is projected to become the fifth leading cause of death globally by 2040.The challenge is not only the number of people affected. It is also the fact that many remain unaware they have kidney disease until substantial damage has already occurred. The World Health Organization notes that kidney disease frequently remains symptomless in its early stages, making timely screening and diagnosis critical.The rise of CKD is closely linked to modern health trends. Increasing rates of diabetes, hypertension, obesity, cardiovascular disease, ageing populations, and unhealthy lifestyle habits have all contributed to the growing burden.Experts also point to another factor: improved detection. More healthcare systems are testing kidney function than before, revealing cases that might have gone unnoticed in the past.The World Health Organization recently highlighted that kidney disease is rising alongside diabetes, hypertension, and population ageing, creating a major public health challenge worldwide.For countries such as India, where diabetes and high blood pressure affect millions, the implications are significant. CKD does not simply affect the kidneys. It increases the risk of heart disease, disability, hospitalisation, and premature death.The first paper in The Lancet Series focuses on advances in diagnosing and detecting CKD.Researchers highlight how traditional testing methods are evolving. New approaches involving cystatin C-based kidney function estimates, albuminuria testing, advanced imaging, artificial intelligence, and multiomics technologies are improving the ability to detect kidney disease earlier and more accurately.One of the key messages from the paper is simple but powerful: early detection saves kidneys.The authors argue that screening strategies based on estimated glomerular filtration rate (eGFR) and albuminuria are becoming increasingly cost-effective, especially now that newer treatments can slow disease progression.The study also raises concerns about unequal access to testing. Many low- and middle-income countries still lack the laboratory infrastructure and healthcare resources needed for widespread screening. As a result, millions remain undiagnosed until the disease reaches advanced stages.One of the most interesting findings from the second paper is that kidney disease does not affect everyone in the same way.The researchers found important biological differences between males and females in kidney structure, function, disease progression, and response to treatment. But many treatment guidelines still fail to account for these differences.The paper explores how genetics, hormones, and epigenetic factors influence kidney health. It also calls for more sex-specific research so future treatments can be tailored more effectively.This is an important shift. For years, medical research often treated patients as a single group. The Lancet authors argue that understanding these differences could improve diagnosis, treatment outcomes, and long-term disease management.In practical terms, it means the future of kidney care may become more personalised rather than following a one-size-fits-all model.The third paper offers some encouraging news.Researchers describe major advances in therapies that target the shared pathways linking kidney disease with diabetes, obesity, cardiovascular disease, and chronic inflammation.Several newer drug classes, including SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and GLP-1 receptor agonists, have shown promising results in slowing CKD progression and improving cardiovascular outcomes.But the authors also stress that treatment is becoming increasingly complex.Many people with CKD live with multiple health conditions at the same time. Managing diabetes, heart disease, obesity, medications, and kidney disease together requires coordinated care and careful decision-making.The study highlights the need for integrated healthcare systems that can identify high-risk patients earlier and ensure they receive comprehensive treatment rather than fragmented care.While scientific breakthroughs are advancing kidney care, prevention remains one of the strongest tools available.According to Aman Puri, Founder of Steadfast Nutrition, dietary habits can significantly influence kidney health. "A balanced diet plays a key role in optimal health and disease prevention. However, incorrect diet planning or excessive consumption of nutrients can cause side effects too. While consuming the right nutrients in moderation can benefit health, excessive consumption can affect organ health, particularly that of the kidneys," he explained.Puri also noted, "Emerging dietary trends may impact the kidneys as these involve a higher consumption of protein, sodium, unhealthy fats and sugar, which harm kidney health. Though high-protein diets are intended to manage weight, diabetes and build muscles, excessive intake of protein can put a strain on the kidneys, impairing renal function."He also warns people not to ignore early symptoms."Persistent swelling of hands, ankles, lower legs, and eyes can be seen as an early sign of impaired kidney function."To support kidney health, Puri recommended moderating protein intake, reducing sodium consumption, staying adequately hydrated, limiting excess caffeine and alcohol, and maintaining a balanced intake of minerals."You can prevent or manage kidney strain by making changes in your dietary patterns. Normal urine output, no swelling, no fatigue or increased blood pressure are signs that your kidneys are healthy," he said.The importance of this series goes beyond academic research.It presents a roadmap for tackling one of the fastest-growing health challenges of the century. The three studies collectively call for earlier diagnosis, more equitable access to testing, personalised approaches to treatment, and wider implementation of effective therapies.They also reinforce a crucial message: kidney disease should no longer be viewed as a specialist concern. It is deeply connected to diabetes, obesity, heart disease, ageing, and overall public health.The WHO has already recognised kidney disease as a major global health issue and has urged countries to strengthen prevention, early detection, and access to treatment.For millions of people, the future of kidney health may depend not only on new medicines but also on something much simpler: knowing the risks before symptoms appear.Medical experts consultedThis article includes expert inputs shared with TOI Health by:Aman Puri, Founder, Steadfast Nutrition.Inputs were used to highlight the growing global burden of chronic kidney disease, key findings from The Lancet’s newly published CKD Series, recent advances in diagnosis and treatment, and the urgent need for greater awareness, early detection, and preventive measures to reduce the rising impact of kidney disease worldwide.