12 WELLNESS
The HEALTH | March-April. 2026
Silent kidney threat
• CKD is a " quiet " disease; it often progresses without symptoms until advanced.
• Women have a slightly higher CKD prevalence than men, and may unknowingly dismiss early symptoms as stress, hormones, or ageing.
• Prioritising women ' s kidney health is essential for personal wellbeing and to sustain care for others.
CHRONIC Kidney Disease( CKD) is often described as a " quiet disease ", one that progresses silently until damage is advanced. The worldwide prevalence of CKD shows that women develop the condition at a rate of 11.8 per cent while men develop it at a rate of 10.4 per cent. The Malaysian data show the same distribution pattern, with women having a 14 per cent prevalence rate, slightly exceeding men at 12 per cent.
According to Sunway Medical Centre ' s Consultant Nephrologist and Kidney Transplantation Physician, Dr Rosnawati Yahya, the gender gap is not always obvious in day-to-day practice.
" What we consistently see is that metabolic conditions like diabetes and hypertension still drive the majority of CKD, and these affect men and women in fairly similar numbers," she said.
DIABETES AND HYPERTENSION
Up to 86 per cent of CKD cases in kidney centres are caused by metabolic disease. The Malaysian Dialysis and Transplant 2023 Registry data show that diabetes and hypertension are the main causes of kidney failure, accounting for 56 per cent and 30 per cent of cases, respectively. The two conditions operate in the background, gradually damaging the kidneys over multiple years without causing any apparent signs.
What remains concerning is that so many people find out about their kidney condition too late. Many only discover they have CKD when kidney function has already declined significantly, sometimes
Dr Rosnawati Yahya
SILENT DRIVERS: Hypertension and diabetes account for the majority of chronic kidney disease cases seen in kidney centres.
just when dialysis becomes an immediate necessity.
" This is why screening is important. The first three stages of CKD are usually asymptomatic. If you wait for symptoms, you are already late."
WHEN GENDER DOES MATTER
While kidney disease can affect anyone, women are more likely to experience autoimmune-related kidney conditions. One of the most common is lupus nephritis, a complication of systemic lupus erythematosus( SLE). Although rarer in men, the symptoms and kidney damage are often more severe when they occur.
" SLE mainly affects women, with female-to-male ratios as high as 9 to 1. When it involves the kidneys, women still make up most cases."
MISSED SYMPTOMS
Dr Rosnawati shared one of the reasons CKD remains underdiagnosed, particularly among women, is that its symptoms are easily dismissed. Symptoms are frequently mistaken for everyday life or hormonal changes, such as: Persistent tiredness or fatigue that is usually blamed on being too busy with household, work or childcare. Lethargy that is often dismissed as anaemia, menstrual symptoms or tiredness. Frequent night-time urination, which some women attribute to weakened pelvic floor muscles after childbirth. Swelling in the legs, ankles or face, which may be dismissed as fluid retention.
" Women often normalise these symptoms. They assume it is stress, ageing, or hormones instead of kidney disease."
However, she shared some red flag symptoms that could indicate CKD, such as changes in urination( frequency, colour, or foamy urine), loss of appetite or nausea, or high blood pressure that is hard to control.
Blood test results can be misleading, especially for women. Creatinine levels, a
" Many only discover they have CKD when kidney function has already declined significantly, sometimes just when dialysis becomes an immediate necessity. "
- Dr Rosnawati Yahya