On a recent episode of PeerPOV: The Pulse on Medicine, Salvatore Viscomi, MD, highlighted the increasing prevalence of chronic kidney disease and called on the healthcare system to increase screening and prevention efforts.

A t least 90% of people with chronic kidney disease (CKD) are unaware that they have the disease, and it’s not just in certain parts of the world. That’s throughout the world.

I think the kidneys have done a poor job marking themselves as an organ compared with other organs. Heart disease and breast cancer have had successful champions.

Also, CKD ranked #36 on the list for mortality not too long ago. In 2040, it’s going to be #5, so it’s increasing as a problem. But it didn’t start off as a high-priority problem. That may be part of it.

The Impact of Climate Change, Plus Looking for Solutions

In CKD, with the warmer climate, we’ve seen an increase in the number of younger people in certain occupations with repeated kidney injury, which results in CKD and crashing into dialysis. This is not going away.

We need to be aware of the risk factors for heat-induced kidney injury. What occupations are at risk? What are the genetic risk factors?

At the same time, treating CKD has involved dialysis for the most part, and dialysis is not climate-friendly. There are a lot of CO2 emissions and water waste. More people are on dialysis; the numbers are staggering and increasing year after year. It’s a vicious cycle that we need to stop on both ends. One, we need to have less dialysis, so there are fewer CO2 emissions, and we need to identify people at risk so we can implement interventions so that these fairly young people don’t end up with permanent kidney damage.

CKD is a neglected area, and there’s an opportunity for it to be recognized, particularly in light of the increasing prevalence and mortality and the unsustainability of dialysis. There’s an opportunity to identify people at risk. It’s not only people with diabetes, but also people with high blood pressure and family history.

There are 40 million Americans with CKD. How do we make sure they’re identified? How do we make sure they’re engaged and we’re monitoring them serially?

It’s also an opportunity to understand the disease better. If you’re longitudinally measuring people, you will understand the risk of progression.