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Michael Donohoe, an International Diabetes Federation (IDF) Blue Circle Voice advocate from the United States, was diagnosed with type 2 diabetes in August 1996. More than two decades later, in November 2019, he learned he was also living with diabetes-related kidney disease. Kidney complications were not new to his family. Both his father and grandmother had experienced nephropathy. Yet Michael says he received little information about his own risk.
Two and a half years later, his primary care physician referred him to a nephrologist, who diagnosed stage 3A chronic kidney disease (CKD). With guidance from a nutritionist specialising in diabetes and kidney health, along with adjustments to his medication and diet, Michael stabilised his condition.
Michael’s experience reflects a growing global health challenge. Up to 40% of people living with diabetes develop chronic kidney disease, making it one of the most common and serious complications of the condition. The number of cases continues to rise. Between 1990 and 2017, CKD among people with type 2 diabetes increased by 74%.
As diabetes becomes more common, especially in low- and middle-income countries, the risk of kidney damage is also increasing. Today, CKD affects more than 850 million people worldwide. Many remain undiagnosed until the disease has progressed significantly. For people living with diabetes, kidney health must therefore be a central part of care. Early detection, timely treatment and equitable access to healthcare can prevent complications and improve quality of life.
This message resonates strongly with the theme of this year’s World Kidney Day – Kidney Health for All: Caring for People, Protecting the Planet – which calls for greater awareness, prevention and sustainable healthcare solutions.
Today, CKD affects more than 850 million people worldwide. Many remain undiagnosed until the disease has progressed significantly
The kidneys play a vital role in filtering waste and excess fluid from the blood. However, high blood glucose levels can damage the tiny blood vessels in the kidneys, reducing their ability to function. High blood pressure, which frequently occurs alongside diabetes, adds further strain.
Over time, this damage can lead to chronic kidney disease. One of the challenges with CKD is that it often develops slowly and without noticeable symptoms in its early stages. As a result, many people are unaware they have kidney disease until kidney function has already declined.
If CKD progresses without treatment, it can lead to end-stage renal disease, when the kidneys can no longer perform their essential functions. At this stage, survival depends on dialysis or a kidney transplant.
The consequences extend far beyond physical health. Advanced kidney disease can affect mental well-being, employment and family life. It also places a significant burden on healthcare systems and increases the risk of cardiovascular disease.
For these reasons, preventing kidney damage and detecting CKD early should be essential priorities in diabetes care.
Advanced kidney disease can affect mental well-being, employment and family life. It also places a significant burden on healthcare systems and increases the risk of cardiovascular disease
Michael Donohoe’s diagnosis prompted important lifestyle changes. He began focusing more closely on blood glucose management, adjusted his diet and incorporated regular walking into his routine.
The diagnosis also had a strong emotional impact. Kidney failure had affected both his father and grandmother, making the news particularly difficult to process. Although he did not receive specific psychological support, he says his healthcare team has provided valuable guidance.
Michael’s experience highlights an important point: CKD can remain silent for many years. Because of this, regular screening is critical for people living with diabetes or other risk factors.
Early diagnosis can change outcomes. When kidney disease is identified in early stages, treatment and lifestyle adjustments can slow – or sometimes halt – progression.
Screening is straightforward and affordable. Two common tests are used:
These tests are simple, non-invasive and widely available in many healthcare systems.
When combined with good diabetes management, early detection can protect kidney health and prevent severe complications.
Early diagnosis can change outcomes. When kidney disease is identified in early stages, treatment and lifestyle adjustments can slow - or sometimes halt - progression
Although CKD affects people worldwide, its impact is not evenly distributed. Social, economic and geographic factors strongly influence access to prevention, diagnosis and treatment.
People living in low-resource settings often face major challenges. Limited healthcare infrastructure, shortages of trained healthcare professionals and the high cost of treatment can delay diagnosis and care.
Certain populations experience additional barriers. Women, people from the global majority and communities with fewer resources frequently encounter delayed diagnosis or reduced access to specialised care.
Environmental factors may also worsen the situation. Climate change is increasingly linked to health risks that affect kidney function. Heat stress, dehydration and air pollution can contribute to kidney damage, particularly among vulnerable populations.
As a result of these complex challenges, many experts advocate multisectoral approaches to kidney health. Addressing CKD requires collaboration across healthcare systems, governments, civil society organisations and communities.
Policies that consider social, economic and cultural factors are more likely to reach people most at risk.
Environmental factors may also worsen the situation. Climate change is increasingly linked to health risks that affect kidney function
Behind the statistics are millions of individual stories. For many people living with diabetes and CKD, advocacy becomes a powerful tool for change.
Salih Hendricks, an IDF Blue Circle Voice advocate from South Africa, understands this reality personally. Before receiving his diagnosis of type 1 diabetes at the age of 12, he experienced several symptoms linked to kidney complications.
The diagnosis came with significant emotional challenges. At the time, psychological support was not available. Reflecting on his experience, he explains:
“No psychological support was available, which as a boy of 12 made my condition even more challenging to accept. From then until today, I have been dealing with the psychological impact of my diagnosis and trying to cope.”
Living with both diabetes and kidney disease continues to affect Salih’s life. However, advances in diabetes technology have helped him better manage his health, while access to modern monitoring tools has improved both control and daily care.
Salih’s story highlights the importance of ensuring that people living with chronic conditions receive not only medical care but also emotional support
While many countries face challenges, some have introduced policies that have significantly improved kidney health outcomes.
Uruguay offers a strong example. Since 2009, the country has required CKD screening for high-risk populations during routine health check-ups. Under this policy, people living with diabetes or hypertension undergo urine and serum creatinine tests every six months. If abnormalities are detected, they are referred to a general practitioner for further assessment and treatment.
Uruguay has also taken an important step by including dialysis under universal health coverage since 1981. This policy ensures that people with advanced kidney disease can access life-saving treatment regardless of their financial situation. These measures have strengthened the country’s kidney care system. Improved screening has enabled earlier diagnosis and helped reduce severe CKD cases.
Uruguay’s experience demonstrates how system-level policies can transform health outcomes when prevention and equitable access are prioritised.
Since 2009, Uruguay has required CKD screening for high-risk populations during routine health check-ups
Perseus Propere, an IDF Blue Circle Voice advocate from Saint Lucia, was diagnosed with type 1 diabetes at age seven in 1991 and later with stage 2 chronic kidney disease in 2008. Although his doctor had warned him about the risk, he says he did not fully understand the implications at the time.
Reflecting on his experience, he says:
“If more information had been available about diabetes, I wouldn’t have the health issues I have today. There should be more sustainable and affordable diabetes prevention and management programmes.”
Living with both kidney disease and diabetic retinopathy also had a significant psychological impact. Perseus sought counselling to help cope with depression and anxiety. Support from family and friends played a crucial role during this period.
Today, he advocates for better education, prevention programmes and improved access to healthcare and treatment.
When people living with diabetes understand the importance of kidney health, they can take steps to protect it. Learning about blood glucose control, blood pressure management and regular screening empowers individuals to act early.
Healthcare professionals also benefit from ongoing education. Access to the latest evidence-based guidance helps ensure that treatment reflects current knowledge and best practice. Community-based programmes can further strengthen prevention efforts. By raising awareness and promoting early testing, they can reach people who might otherwise remain undiagnosed. Together, these initiatives can reduce preventable complications and improve the lives of people living with diabetes.
Learning about blood glucose control, blood pressure management and regular screening empowers individuals to act early
The intersection of diabetes and chronic kidney disease represents one of the most pressing global health challenges today. However, the tools to address it already exist.
Early detection through simple blood and urine tests can identify kidney damage before it becomes severe. Effective management of diabetes and hypertension can slow disease progression. At the same time, equitable healthcare policies can ensure that treatment reaches those who need it most.
World Kidney Day 2026 reinforces a powerful message: kidney health must be accessible to everyone.
Achieving this goal requires collaboration across sectors. Governments, healthcare providers, researchers, advocacy organisations and communities all have a role to play.
By strengthening prevention strategies, expanding access to treatment and investing in sustainable healthcare systems, the global community can reduce the burden of chronic kidney disease.
Protecting kidney health ultimately means protecting lives. Through continued advocacy and coordinated action, people living with diabetes can look forward to healthier futures and improved quality of life.
