SINGAPORE, 17 AUGUST 2026—Chronic kidney disease (CKD) is currently ranked the ninth leading cause of death globally[1]. However, up to half of the cases may remain undetected despite the availability of simple urine and blood tests.
The stark healthcare message is laid out in a landmark series of research papers, published in The Lancet by a global team of experts—from institutions including the SingHealth Duke-NUS Academic Centre, the University of Glasgow, the University of Toronto and Peking University—who are now calling for a renewed focus on CKD diagnosis and treatments.
CKD, a long-term condition where the kidneys do not work as well as they should, currently affects 844 million adults worldwide and is projected to become the fifth leading cause of death by 2040. In Singapore, the prevalence of chronic kidney disease stands at 14.9 per cent[2]; while around six new patients are diagnosed daily[3].
Potentially, 7 out of 10 individuals with CKD in Singapore may be unaware that they have the disease[4], meaning that 70 per cent of total cases may be undiagnosed in the community.
Early diagnosis of CKD is critical for the early initiation of intervention to halt or delay its progression, and the condition can be detected using simple urine and blood tests that individuals can request at General Practitioner clinics or polyclinics.
In mild to moderate stages of CKD, many people may remain asymptomatic. Symptoms of CKD may develop only in the most severe or advanced stages, close to the time of kidney failure when dialysis or kidney transplant is required. Without early diagnosis and initiation of treatment, kidney disease may lead to kidney failure, resulting in a need for dialysis or even causing early mortality.
The lack of symptoms contributes to low rates of diagnosis and low rates of awareness of CKD both among patients and health professionals. Currently it is estimated that around 30-50 per cent of CKD cases are not diagnosed in high-income countries like the United Kingdom, with the percentage of undiagnosed cases in middle and lower-income countries thought to be even higher. In some groups, the percentage of undiagnosed cases is particularly high: non-white people and women may be up to twice as likely to be undiagnosed as white men.
Although the World Health Assembly adopted a landmark resolution recognising kidney health as a global priority in 2025[5], progress in diagnosing CKD early and early initiation of guidelines-directed medical therapy for CKD has remained suboptimal globally and in Singapore.
The new landmark series of papers, authored by researchers from around the world and led by Dr Jennifer Lees from the University of Glasgow, details the full extent of the global healthcare burden caused by CKD, including its delayed diagnosis, which could in turn lead to the progression of CKD to advanced stages and kidney failure requiring dialysis, as well as increased risk of all-cause mortality and cardiovascular mortality. The leading cause of CKD is cardiovascular disease.
Dr Lees, Senior Clinical Research Fellow at the University of Glasgow and Honorary Consultant Nephrologist at NHS Greater Glasgow & Clyde, said:
“Chronic kidney disease remains one of the most concerning conditions currently impacting global health. The overriding message from our series of research papers is that there remains a pressing need for attention and resource to be focused on this condition.”
“There is huge potential for early diagnosis and initiation of treatment by testing urine for protein routinely across a range of healthcare settings and among at risk population such as those with diabetes, high blood pressure, obesity, heart disease and family histories of kidney disease. This may be particularly important in those who are at risk of underdiagnosis, including non-white populations and women,” she added.
The three research papers also offer detailed insights into recent advances in CKD, including gender differences in kidney disease, different causes and mechanisms of kidney disease and its consequences for global health, as well as the opportunities provided by advances in treatment strategies. They highlight the differences in treatments and diagnosis between men and women, alongside the need for integrated approaches to CKD prevention and treatments across a range of healthcare settings.
There are many drivers of CKD, including diabetes, hypertension, obesity and cardiovascular disease, with the risk of developing the disease increasing with age. While it can affect anyone, chronic kidney disease is more common in people who are Black or of South Asian origin. In Singapore, patients who are ethnically Malay have the highest incidence of kidney failure[6].
Compared to those without CKD, people with CKD are more likely to be hospitalised, develop complications while in hospital and also be re-admitted.
Clinical Professor Wang Yee Moon Angela,a senior researcher with the Medicine Academic Clinical Programme within the SingHealth Duke-NUS Academic Medical Centre and a Senior Consultant at Singapore General Hospital's Department of Renal Medicine, co-authored two of the papers. She said:
“The rise of chronic kidney disease in Singapore is driven by increasing rates of diabetes, hypertension, obesity and lifestyle-related risk factors and an ageing population. Early detection through screening at-risk populations, coupled with personalised risk assessment and preventive measures as well as optimised implementation and adherence to guidelines-directed medical therapies, could help to delay the progression of kidney disease and lower the alarming rates of kidney failure. Additionally, lifestyle interventions remain an important foundation therapy for management of CKD.”
With advances made in biomarkers, kidney biopsies and genetic testing that deepen our understanding of the causes of kidney disease—along with emerging digital technologies and artificial intelligence—there are now unique opportunities to improve patient outcomes through precision medicine, added Clin Prof Wang.
Moving forward, the authors hope that the series of papers will raise global and local awareness of the need to prevent CKD and encourage those at risk to be screened for the condition early.
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Paper 1: https://doi.org/10.1016/S0140-6736(26)00702-6
Paper 2: https://doi.org/10.1016/S0140-6736(26)00654-9
Paper 3: https://doi.org/10.1016/S0140-6736(26)00653-7
[1] Global Burden of Disease Study 2023
[2] National Population Health Survey 2024, SingStat.
[3] Singapore Renal Registry Annual Report 2023.
[4] This is based on a 2023 CNA report.
[5] In 2025, the World Health Assembly announced a resolution on kidney disease, marking a significant milestone on the global fight against kidney disease. The resolution aims to promote kidney health across the life course, improving early detection and management of kidney disease–especially in people with diabetes and hypertension–and ensuring equitable access to essential medicines and services.
[6] This is based on a 2023 study published in the Singapore Medical Journal
