KUALA LUMPUR: Chronic kidney disease (CKD), often described as a "quiet disease”, progresses silently and is frequently detected only after significant kidney damage has occurred, prompting experts to urge women to prioritise early screening.
Consultant Nephrologist and Kidney Transplantation Physician at Sunway Medical Centre (SMC), Sunway City, Dr Rosnawati Yahya said many patients only discover their condition when kidney function has already declined substantially.
"The first three stages of CKD are usually asymptomatic. If you wait for symptoms, you are already late,” she said in a statement released in conjunction with World Kidney Day, observed on March 12.
She added that the majority of CKD cases are still driven by metabolic conditions like diabetes and hypertension, which affect men and women in fairly similar numbers.
Data from the Malaysian Dialysis and Transplant 2023 Registry shows diabetes accounts for 56% of kidney failure cases, while hypertension contributes 30%.
According to Dr Rosnawati, early symptoms of CKD are often overlooked because they resemble common conditions such as fatigue, hormonal changes or anaemia.
Among the signs are persistent tiredness, lethargy, frequent night-time urination, and swelling in the legs, ankles or face.
"Women often normalise these symptoms, assuming it is stress, ageing, or hormonal changes, instead of kidney disease,” she added.
She also cautioned that blood test readings may sometimes mask early kidney problems in women.
"Since women generally have less muscle than men, a ‘normal’ creatinine level might still mask early kidney issues.
"A reading of 90 may be fine for a large man, but in a petite woman it could signal reduced kidney reserve,” she explained.
Dr Rosnawati said systemic lupus erythematosus (SLE) mainly affects women, with female-to-male ratios as high as 9:1, and kidney involvement remains more common among female patients.
She also pointed out that certain life stages, such as pregnancy and menopause, may increase long-term kidney risks.
Complications such as preeclampsia and gestational diabetes may indicate underlying vascular or metabolic problems, increasing the risk of hypertension, proteinuria and CKD two to four times later in life.
"Additionally, polycystic ovary syndrome (PCOS) has emerged as a significant but under-recognised risk factor. It is closely linked to insulin resistance, obesity and metabolic syndrome.
"It can also lead to diabetes and high blood pressure earlier in life, both major causes of kidney damage over time,” she said.
Dr Rosnawati advised women, especially those with diabetes, hypertension, obesity, autoimmune diseases or pregnancy complications, to undergo regular screening.
She said three simple tests can help detect kidney disease early -- a blood test for kidney function, a urine test for protein and a blood pressure check.
"Protein in the urine is one of the earliest signs of kidney damage. Early detection changes everything as there are many treatment options available.
"Our goal is preservation. If we can reduce kidney decline from 10% a year to just 2%, many patients may never need dialysis,” she said. — Bernama
