Chronic kidney disease is a growing health problem around the world, yet it often develops silently. Many people do not feel unwell in the early stages, and routine blood tests may appear normal.
Because of this, kidney disease is often discovered only after serious and sometimes irreversible damage has already occurred.
A new large study from researchers at Karolinska Institutet in Sweden suggests that small changes in kidney function, even when test results fall within the so-called normal range, may reveal who is more likely to develop chronic kidney disease later in life.
Chronic kidney disease affects an estimated 10 to 15 percent of adults worldwide. The condition reduces the kidneys’ ability to filter waste and excess fluid from the blood. Over time, this can lead to fatigue, swelling, heart problems, and eventually kidney failure.
If kidney failure occurs, patients may need dialysis several times a week or a kidney transplant to survive. Global health experts estimate that by the year 2040, chronic kidney disease will become one of the top five causes of years of life lost, highlighting the urgent need for earlier detection and prevention.
One of the biggest challenges in kidney care is screening. Unlike conditions such as high blood pressure or diabetes, kidney disease is not routinely screened for in the general population.
Many patients are diagnosed only after they have already lost more than half of their kidney function. At that point, treatment options are limited and mainly focus on slowing further decline rather than restoring health.
The new study, published in the journal Kidney International, aimed to rethink how kidney function is evaluated. Doctors usually assess kidney health using a measure called estimated glomerular filtration rate, or eGFR. This value estimates how well the kidneys are filtering blood.
Traditionally, clinicians rely on a fixed cutoff, often an eGFR of 60, to decide whether kidney function is normal or impaired. However, this one-size-fits-all approach does not take into account natural differences related to age and sex.
To address this problem, the researchers created population-based reference charts for eGFR. Instead of focusing on a single number, these charts show how a person’s kidney function compares with others of the same age and sex.
The idea is similar to the growth and weight charts used for children, which help doctors spot health risks even when values still fall within an accepted range. According to the researchers, this approach allows risk to be identified earlier, when preventive action may still be effective.
To build these charts, the research team analyzed health data from more than 1.1 million adults living in the Stockholm region of Sweden. This group represented about 80 percent of residents aged between 40 and 100 years.
The study included nearly seven million eGFR test results collected over a 15-year period, from 2006 to 2021. This large dataset allowed the researchers to create detailed distributions of kidney function by age and sex.
The findings revealed a clear pattern. People whose eGFR levels were far below the average for their age and sex faced significantly worse outcomes.
Those below the 25th percentile had a much higher risk of progressing to kidney failure that required dialysis or a transplant. The study also found a U-shaped relationship with mortality, meaning that people with unusually low or unusually high eGFR values had an increased risk of death.
Importantly, the study showed that many opportunities for early action are currently being missed. Among people whose eGFR values were above 60, which is typically considered normal, but still below the 25th percentile for their age, only about one in four had received further testing for urinary albumin.
This urine test is crucial because it can detect early kidney damage and help guide treatment decisions.
The researchers gave an example to illustrate the problem. A 55-year-old woman with an eGFR of 80 would usually not raise concern in routine clinical practice. However, when placed on the new reference charts, this value falls around the 10th percentile for women of her age.
According to the study, this level is associated with a three-fold higher risk of needing dialysis in the future. Without the chart-based approach, this risk would likely go unnoticed.
To help translate their findings into real-world practice, the researchers developed a free web-based calculator for healthcare professionals.
This tool allows clinicians to see where a patient’s eGFR falls compared with age-based population norms. The goal is not to replace existing guidelines, but to support better decision-making and encourage timely follow-up testing and prevention strategies.
In reviewing the study’s findings, the message is clear: kidney disease risk exists on a spectrum and does not begin only when test results cross an arbitrary threshold. By paying attention to how kidney function compares within age and sex groups, clinicians may be able to identify vulnerable patients years earlier than before.
This earlier awareness could lead to simple but powerful interventions, such as closer monitoring, lifestyle changes, blood pressure control, or medication adjustments.
While further research is needed to confirm how best to use these charts in different populations, the study represents a meaningful step toward preventing chronic kidney disease rather than reacting to it too late.
If widely adopted, this approach could reduce the number of people who progress to kidney failure and improve long-term health outcomes on a global scale.
If you care about kidney health, please read studies about pesticide linked to chronic kidney disease, and this drug may prevent kidney failure in people with diabetes.
For more health information, please see recent studies about drug duo that may treat kidney failure, and results showing these vegetables may protect against kidney damage.
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