Kidney disease, the silent epidemic threatening South Africans

Chronic kidney disease (CKD) is now the seventh leading cause of death worldwide. With kidney disease affecting more than 10% of South Africans, the nation is grappling with a silent but deadly epidemic. 

This is according to Dr Edgar Lutaaya, Nephrologist and Specialist Physician at Mediclinic Potchefstroom, who says that kidney disease is often underdiagnosed and underreported. “The prevalence of kidney disease in South Africa is alarmingly high, surpassing the global median of 9.5%. Yet, due to challenges in data collection, these figures may still be underestimated.”

The rise in kidney disease cases is linked to an increase in non-communicable diseases, with surveys indicating that sub-Saharan Africa bears the greatest burden. Hypertension alone has been documented in as many as 55% of kidney disease patients in South Africa, further highlighting the urgency of addressing this issue.

"The most common risk factors for kidney disease in South Africa mirror global trends, largely due to urbanisation and lifestyle changes," explains Dr Lutaaya. "Hypertension and diabetes mellitus are the leading causes, followed by chronic glomerulonephritides and tubulointerstitial diseases. These lifestyle-related conditions are driven by unhealthy dietary habits, high salt intake, and sedentary living."

The role of salt and blood pressure management

A key dietary factor in kidney disease progression is excessive salt intake. "Modern western diets typically contain 8-10 grams of salt per day. This, coupled with impaired salt handling in old age, contributes to the development of hypertension," warns Dr Lutaaya. "Studies have shown that reducing salt intake can help manage hypertension which in turn will slow the progression of kidney disease."

Conversely, low blood pressure is not a direct risk factor for kidney disease, but excessive reductions – whether due to overtreatment of hypertension or trauma – can result in acute kidney injury. "The kidneys have a threshold for compensating for blood pressure fluctuations and excessively low levels can compromise kidney function."

Prevention is key

Preventing kidney disease requires a multi-faceted approach that involves both individuals and healthcare providers. "For the general population, adopting a healthy diet and engaging in regular exercise are crucial steps," says Dr Lutaaya. "For those with chronic conditions, adhering to prescribed treatments can significantly reduce the risk of kidney complications."

Dr Lutaaya also emphasises the importance of early medical intervention. "Education should be prioritised to encourage early engagement with primary healthcare providers. This needs to be done in collaboration with community leaders and practitioners of traditional medicine in remote communities. Early screening for at-risk individuals is critical for early diagnosis of kidney disease and prompt referral to a nephrologist contributes to slowing progression of kidney disease."

Mediclinic Southern Africa is actively working to raise awareness and improve early detection of kidney disease. "We focus on public awareness campaigns encouraging routine check-ups for hypertension and diabetes," says Dr Lutaaya. "Additionally, we engage general practitioners and specialists through educational initiatives to enhance early detection and intervention."

Today’s International Kidney Awareness Day serves as a reminder that knowledge is power. “Globally, only 6% of the general population and 10% of high-risk individuals are aware of their kidney disease status. By undergoing regular screenings and seeking early medical intervention, South Africans can take proactive steps to reduce their risk of kidney disease,” Dr Lutaaya concludes.