Each month, we open our newsletter editorials to special guests from our community who bring unique perspectives, expertise and lived experiences to important health topics. In our March 2025 issue, we are honoured to feature Daniel Gallego, President of the European Kidney Patients’ Federation (EKPF), who highlights the connection between diabetes and chronic kidney disease (CKD).
As EKPF President, I want to draw attention to a critical yet often overlooked issue: the link between diabetes and CKD. This connection is silent but deadly, affecting millions across Europe. Alarmingly, one in three people living with diabetes (PwD) will develop CKD. Despite these staggering numbers, awareness remains dangerously low, not only among PwD but also within the general population.
Diabetes is the leading cause of CKD worldwide. Persistently high blood glucose levels damage the kidneys, progressively impairing their function and ultimately leading to kidney failure. When the blood vessels in the kidneys are compromised, their ability to filter blood effectively diminishes, causing fluid retention, weight gain and ankle swelling. Unfortunately, many people living with both diabetes and CKD experience no symptoms until the disease has reached an advanced stage. This makes early awareness and diagnosis essential. Yet, screening for kidney function does not happen early enough. Managing both conditions can be extraordinarily complicated, requiring careful management of blood glucose, blood pressure and different medications, and the constant fear of kidney failure.
For too long, CKD has been absent from healthcare and diabetes conversations, often overshadowed by other diabetes-related complications. But for those living with the conditions, the reality is tough. Once kidney function declines to stage 4 (advanced CKD) or stage 5 (kidney failure), it cannot be restored and individuals need to undergo kidney replacement therapies such as dialysis or transplantation. Beyond the clinical, financial and environmental burden, the emotional and psychological toll is considerable.
People must be at the centre of this discussion. Education programmes need to be improved so that PwD fully understand their risk of CKD. Regular screening for kidney function must be integrated into diabetes care and access to specialised physicians and therapies that can slow disease progression must be expanded. Addressing disparities in healthcare access is crucial – everyone deserves high-quality care, regardless of their socioeconomic status.
The EKPF advocates for policy changes that prioritise prevention, early detection, research and person-centred care. However, we cannot do this alone. We need governments, healthcare professionals (HCPs), industry and patient organisations to come together in addressing this crisis. Prevention, awareness and innovation, along with improved risk communication strategies, must be the focus of our collective efforts.
To all individuals living with diabetes and CKD: you are not alone on this journey. Together, we can raise awareness, drive policy change and ensure that kidney health does not remain silent and unseen.
