Chronic kidney disease (CKD) has emerged as a critical public health challenge, affecting nearly 100 million people in Europe and contributing significantly to mortality and healthcare costs. With the ageing of the population and the increasing prevalence of diabetes, hypertension and obesity, the burden of CKD is expected to rise dramatically in the coming decades. In response to this urgent situation, European stakeholders are advocating for a comprehensive approach that prioritises early detection, equitable access to care and public awareness. The need for system-wide transformation is underscored by both the escalating human and economic costs of CKD and the availability of effective interventions.
The Burden of CKD: Health, Economic and Environmental Impact
CKD is a rapidly growing health threat across Europe, with particularly high and increasing prevalence in Eastern regions. The disease contributes to cardiovascular mortality and kidney failure, leading to severe personal and societal costs. Premature deaths linked to CKD are expected to rise significantly, making it one of the top causes of death in several European countries by 2050. Even mildly reduced kidney function or slightly elevated albuminuria levels pose increased mortality risks, which intensify as kidney function worsens.
The financial implications are equally concerning. Healthcare systems in Europe spend over €140 billion annually on CKD-related care, not including indirect costs like lost productivity. Dialysis alone consumes vast resources, with annual per-patient costs surpassing €50,000 for haemodialysis and €30,000 for peritoneal dialysis in many Western European countries. While these figures are somewhat lower in Eastern Europe, they represent a higher percentage of national income. Beyond economics, dialysis also contributes significantly to environmental harm through greenhouse gas emissions, water use and plastic waste. Despite these wide-reaching impacts, only a fraction of Europeans living with CKD are aware of their condition.
Gaps in Detection and Treatment Despite Available Tools
Early detection of CKD is both feasible and cost-effective. Simple and inexpensive diagnostic tools such as estimated glomerular filtration rate (eGFR) and albuminuria measurements are sufficient for identifying CKD. Although eGFR is often automatically reported by laboratories, it is still frequently overlooked in diagnosis. Albuminuria, despite being a key risk indicator, is rarely tested, even among populations at high risk. This diagnostic inertia is troubling, particularly as CKD testing is endorsed in all major guidelines for kidney, diabetic, hypertensive and cardiovascular care.
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This underdiagnosis persists in the face of significant therapeutic progress. New medications, including sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor antagonists and non-steroidal mineralocorticoid receptor antagonists, have demonstrated remarkable success in slowing disease progression and improving cardiovascular outcomes in CKD patients. Initiating treatment even at early stages of the disease—particularly when albuminuria is elevated but eGFR remains normal—can potentially delay kidney failure by decades. Nevertheless, without greater attention to testing and early intervention, many patients are denied the benefits of these innovations.
Raising Awareness and Driving Systemic Change
To address the systemic neglect of CKD, the European Renal Association established the Strong Kidneys Task Force. This initiative targets three key audiences: the public, healthcare professionals and policymakers. The Task Force seeks to increase public understanding of kidney health, promote early detection and timely treatment among clinicians, and foster policy environments conducive to sustainable reform.
In 2025, the Task Force, in collaboration with the European Kidney Health Alliance and the European Kidney Patients Federation, launched the “Protect Your Kidneys, Protect Your Future” campaign. Central to this initiative is the ABCDE Project, designed to engage individuals in assessing their kidney and cardiovascular health. By answering five straightforward questions—concerning albuminuria, blood pressure, cholesterol, diabetes status and kidney function—individuals are empowered to make informed lifestyle changes and seek appropriate medical care. This initiative promotes proactive conversations between patients and healthcare providers and supports access to affordable, effective treatments.
The simplicity of CKD diagnosis and the availability of impactful therapies must now be translated into widespread action. To ensure no one is left behind, systemic efforts must focus on equity—guaranteeing access to quality care, diagnostics, treatment and support regardless of geography or socioeconomic status. The ABCDE initiative provides a replicable model for such change, demonstrating how awareness can act as a catalyst for prevention and improved outcomes.
Chronic kidney disease demands urgent attention as a growing contributor to mortality, economic strain and health system inefficiencies across Europe. While significant therapeutic advances and diagnostic tools are readily available, underdiagnosis and clinical inertia continue to hinder progress. With CKD set to become a leading cause of death in several European countries, a paradigm shift is necessary—one that prioritises prevention, early intervention and equitable care. Through public campaigns, professional engagement and policy advocacy, the Strong Kidneys Task Force is paving the way for this transformation. Ensuring that kidney health is no longer overlooked must be a collective European priority—achievable with as little as five essential questions.
Source: The Lancet Regional Health – Europe
Image Credit: Freepik
