Often silent in its early stages, CKD can progress unnoticed until it causes severe health consequences, profoundly impacting individuals, families, and communities. The disease significantly increases the risk of cardiovascular complications, reduces quality of life, and may advance to kidney failure, where survival depends on life-sustaining kidney replacement therapies such as dialysis or transplantation. Its burden is unevenly distributed, disproportionately affecting disadvantaged populations and exacerbating existing health inequities.
Early detection can save lives. Simple, non-invasive, and cost-effective testing through blood and urine tests can identify kidney dysfunction, enabling timely interventions that slow disease progression. Targeting high-risk populations – people with diabetes, hypertension, cardiovascular disease, obesity, or a family history of kidney disease – is highly effective. Community-based programs can expand access in underserved populations. Detecting CKD early not only preserves kidney function but also reduces the need for resource-intensive treatments and improves long-term outcomes.
Environmental changes are now adding to this burden. Climate-related risks – air pollution, heat stress, dehydration, and extreme weather events – compound the risks of CKD and accelerate its progression
[2]. Rising global temperatures also fuel the spread of tropical diseases that can damage the kidneys. At the same time, treatments for end-stage kidney disease, particularly dialysis, are resource-intensive: they require large volumes of water, energy, and single-use plastics, and generate greenhouse gas emissions. A single hemodialysis session can have a carbon footprint equivalent to driving a car for nearly 240 kilometers. This creates a feedback loop:
kidney disease and climate change worsen each other.
A global turning point has arrived. At the 78th World Health Assembly, the World Health Organization (WHO) adopted its first-ever resolution dedicated to kidney disease
[3]. This historic decision elevates kidney health as a global public health priority, recognizing World Kidney Day as a formal observance and urging action on prevention, awareness, treatment access, and environmental risk reduction.
Call to Action: A Multi-stakeholder Commitment
To build a healthier, more equitable, and more sustainable future for kidney health, we call on governments, health systems, industry, and communities to act together:
- Prioritize prevention, early detection, and timely management of kidney disease. Promote the 8 Golden Rules for kidney health, integrate CKD testing into routine care for high-risk populations, and strengthen public awareness campaigns to encourage early detection and preventive care, ultimately reducing the need for hospital-based interventions.
- Promote equitable access to transplantation. Expanding access to preemptive and early transplantation not only improves survival and quality of life, but also reduces costly dialysis dependence, lowers plastic waste and emissions, and addresses global disparities.
- Transform dialysis toward sustainability. Accelerate innovations in therapies with lower environmental impact, prioritize home-based options such as peritoneal dialysis, and promote eco-friendly practices like water reuse and material recycling, while ensuring that quality of care is never compromised.
- Safeguard patient needs in green kidney care. Sustainability must never come at the expense of patients. Initiatives should target systemic inefficiencies (e.g., energy-efficient machines, toxin-free supplies) and include patient voices to ensure trust, transparency, and co-benefits.
- Invest in implementation pathways for all contexts. Strengthen policies and funding, build partnerships between governments and businesses to support innovation, and support practical solutions for low-resource settings – such as task-shifting, mobile clinics, and manual peritoneal dialysis cyclers.
