Kidney disease has more than doubled in 35 years, with the Middle East facing up to the rising costs of treating the condition as cases surge.
A report released this month showed the Middle East and North Africa have the highest prevalence of chronic kidney disease (CKD) in the world. Research published in The Lancet showed 18 per cent of people have the condition diagnosed, compared with the global average of 14 per cent.
Analysis focused on people who are at least 20 years old and had CKD diagnosed between 1990 and 2023. They were from 204 countries and territories. Iran, Libya, Mauritius, Saudi Arabia and Nigeria were among the countries where CKD has put pressure on the healthcare system.
Related health problems
Driven by poor lifestyle choices, obesity and diabetes, chronic kidney disease is often diagnosed too late to avoid a lifetime of dialysis or the need for organ transplant.
In 2023, CKD was the ninth-leading cause of death worldwide, with the condition responsible for nearly 1.5 million deaths. Doctors have called for better early stage screening to stem the rise in mortality.
“The major causes for CKD is diabetes, blood pressure, obesity and a sedentary lifestyle,” said Dr Ganesh Dhanuka, a nephrology specialist at International Modern Hospital, Dubai. “Now we are more machine-dependent, there's an increasing prevalence of these issues. Smoking, over the counter pills and drinking are other major factors leading to CKD.
“In the Middle East, high temperatures cause frequent dehydration, which eventually leads to kidney failure. It's a chronic problem, eventually the patient will land in dialysis and require a kidney transplant.”
CKD is responsible for 22.35 deaths in every 100,000 people in Saudi Arabia and 43.7 deaths in every 100,000 people in Egypt. The figure is considerably lower in the UAE (8.6) and that is largely because cases are detected early.
Most patients have the condition diagnosed in the end stages. While disease progression is slow, there are few symptoms in the early stages. That makes treating the disease at the advanced stages considerably more challenging and expensive.
“Eventually, the patient dies because of the complications, or dialysis or transplant related complications – that’s why the mortality is increasing,” said Dr Dhanuka. “To diagnose these conditions, we need a few strategies. Every doctor should screen patients for diabetes and blood pressure, and if they are risk they should have a kidney check every six to 12 months. With a consistent, healthy lifestyle the doctor and patient should be able to control it.”
The condition is also a major contributor to cardiovascular deaths. Kidney dysfunction accounted for almost 12 per cent of global cardiovascular deaths in 2023, ranking seventh among risk factors for cardiovascular mortality.
Early screening
Most people with CKD are in stages one to three, highlighting the value of screening, as well as measures to improve blood pressure and glucose control. Doctors have also called for treatments to reduce risk factors and delay the progression of the condition.
However, it remains a challenge to find organs suitable for transplants. That is particularly true in Africa, with people of African heritage more exposed to the disease. Black Americans are about four times more likely to develop kidney failure than white Americans, owing to genetic, medical, social and environmental factors.
Dr Kareem Al Dulaimi, a consultant nephrologist at Medcare Hospital Al Safa, said health conditions that put kidneys under strain tended to result in chronic disease. “Chronic kidney disease tends to be more common in the Middle East largely because the region has a high concentration of individuals with conditions that directly increase kidney strain,” he said. “Factors such as diabetes, hypertension, obesity, metabolic syndrome and recurrent kidney stone issues are particularly prevalent in this part of the world.”
Proactive screening and earlier intervention are considered to be the best ways to tackle the rise in cases. “Improving early diagnosis begins with screening the right people at the right time,” said Dr Al Dulaimi. “Most CKD goes undetected because those who should be tested never undergo screening. Since early CKD is easy to detect, consistently screening these groups is the single most important step towards more effective treatment and improved long-term outcomes.”
Identifying CKD earlier allows doctors to intervene sooner, slow progression more effectively and prevent complications. Dr Azeem Ahamed, a specialist in nephrology at Aster Clinic, Bur Dubai, said the region had some of the world’s highest rates of Type two diabetes and hypertension, which are major contributors to kidney damage.
“Rapid urbanisation, reduced physical activity and dietary patterns rich in salt and processed foods add to this burden,” he said. “Cardiovascular disease, ageing populations, and widespread use of over the counter painkillers also contribute. In several countries, environmental heat stress, dehydration and air pollution are emerging concerns linked to kidney dysfunction.
“Annual kidney screening and urine albumin tests is strongly recommended for individuals with diabetes, hypertension, obesity, or a family history of kidney disease. Early detection allows timely medical therapy that can slow or prevent progression.”
