CHRONIC KIDNEY DISEASE IN GUYANA: THE SILENT HEALTH CRISIS WE MUST NOT IGNORE

By Dr Tariq Jagnarine
Fam Med, Endocrinology/Diabetes

Chronic Kidney Disease (CKD) is steadily becoming one of the most serious yet least-understood health challenges facing families across Guyana. It is a quiet illness, often unnoticed until the kidneys are significantly damaged, earning it a reputation as one of the world’s most silent but deadly conditions. As more Guyanese are diagnosed with diabetes, hypertension, and lifestyle-related disorders, kidney disease has moved from the margins of public-health discussions to the centre of community concern.

What CKD really is
Kidneys are often described as the body’s natural filters, but their role goes far beyond that simple comparison. Every day, they clear waste products from the blood, regulate blood pressure, balance electrolytes, help produce red blood cells, and support bone health. Chronic Kidney Disease occurs when these vital organs gradually lose their ability to perform these functions. This deterioration happens slowly and quietly, sometimes over many years, making early detection difficult without regular checkups.

The facts behind the threat
Globally, over 850 million people are living with kidney disease, and CKD has climbed into the top 10 causes of death worldwide. In the Caribbean, and particularly in Guyana, the rise of kidney disease has been closely linked to increasing rates of diabetes and hypertension. Dialysis centres across the country have seen a growing demand, with many patients only learning about their kidney damage when it has already reached an advanced stage. What makes CKD especially heartbreaking is that it often affects individuals during their most productive years, placing emotional, financial, and social strain on entire families.

Why CKD is becoming more common
The leading causes of CKD are not mysterious; they are part of the everyday health concerns in Guyana. Poorly-controlled diabetes remains the number one cause, as high blood sugar over many years gradually scars and weakens the kidneys’ tiny filtering units. Hypertension follows closely behind; constant pressure in the blood vessels slowly wears down the delicate kidney tissue. Repeated kidney infections, untreated urinary tract infections, long-term use of strong painkillers, and inherited kidney disorders also contribute to the rising number of cases.
Lifestyle changes have played a major role. High-salt diets, sugary beverages, sedentary habits, and late diagnosis of chronic diseases have all created the perfect environment for CKD to flourish.

Why CKD should matter to everyone
CKD is not a disease that stays hidden in hospitals; it affects households, workplaces, and entire communities. When a breadwinner must attend dialysis three times per week, or when a parent becomes too tired to work or take care of children, the ripple effects are far-reaching. Early-stage CKD can be completely manageable, but late detection often leads to sudden lifestyle disruption. This makes awareness the most powerful tool we have.

Signs and symptoms
One of the challenges with CKD is that symptoms are vague and easily mistaken for everyday stress or ageing. Many patients recall months of swelling in the ankles, persistent tiredness, foamy urine, or frequent bathroom visits at night, but dismissed them as “nothing serious”. Other symptoms can include loss of appetite, nausea, itching skin, muscle cramps, or difficulty concentrating. By the time these symptoms appear clearly, the kidneys may have already suffered significant damage.

Diagnosis
Fortunately, diagnosing CKD is simple and painless. A basic blood test that checks creatinine levels and calculates the kidney’s filtration rate (eGFR) gives a clear picture of how well the kidneys are functioning. A urine test can detect protein leakage, one of the earliest signs of kidney damage. Ultrasound imaging can assess kidney size and structure, and blood pressure measurements help determine whether hypertension is contributing to the damage. For individuals with diabetes, high blood pressure, or a family history of kidney problems, these tests should be done annually.

Treatment
There is no cure for CKD, but its progression can be slowed dramatically when detected early. Treatment focuses on managing the underlying causes: keeping blood sugar well-controlled in people with diabetes and ensuring healthy blood-pressure levels in hypertensive patients. Doctors may prescribe medications that help protect the kidneys, reduce inflammation, and correct imbalances in minerals like potassium and phosphorus. Dietary changes also play a crucial role, reducing salt, limiting processed foods, moderating protein intake, avoiding sugary beverages, and choosing fresh fruits and vegetables.
For some people, especially in late-stage CKD, dialysis becomes necessary to remove waste and excess fluid when the kidneys can no longer do so. Others may be candidates for a kidney transplant, which can offer a long-term return to normal life.

Complications
Untreated CKD can lead to severe complications, including heart failure, stroke, severe anaemia, fluid build-up in the lungs, nerve damage, dangerous electrolyte imbalances, and eventually complete kidney failure. Because the kidneys influence so many bodily functions, when they fail, multiple systems begin to struggle. This is why CKD is so often linked to premature death.

Prognosis
The outlook for individuals with CKD varies widely. Those diagnosed early often lead full, productive lives with the help of medication, routine monitoring, and lifestyle adjustments. Those who are diagnosed late may face more aggressive treatments, including lifelong dialysis. However, even in advanced stages, quality of life can improve significantly with proper care, emotional support, and access to medical services.

Prevention
Preventing CKD begins with simple daily habits: drinking enough water, limiting salt, reducing sugary drinks, eating more fruits and vegetables, exercising regularly, and avoiding unnecessary painkillers. Most importantly, people living with diabetes or hypertension must prioritise their checkups, take medication as prescribed, and maintain regular testing. Prevention is far easier than treatment, and it starts long before symptoms appear.