Many patients are only diagnosed with chronic kidney disease (CKD) when symptoms are already advanced. By the time they seek consultation, the disease has often progressed to a stage where treatment is not only complex, but significantly more costly.
This is not just an individual patient story. It reflects a broader national pattern.
CKD affects an estimated 13 million Filipinos, many of whom remain unaware they are already living with the condition. The result is a staggering P592 billion economic burden representing 41 percent of the country’s healthcare expenditure-one that is driven not only by the disease itself, but by how late it is diagnosed.
The scale of the challenge is difficult to ignore. Recent research commissioned by Boehringer Ingelheim suggest that as many as 35.9 percent of Filipino adults may already be living with CKD, more than double the global average. Every hour, another Filipino progresses to chronic renal failure, further increasing the burden on families and the healthcare system.
Perhaps the more uncomfortable question is this: if CKD can often be detected years before symptoms appear, why are so many Filipinos still being diagnosed only after the disease has already progressed?
CKD develops gradually and often without noticeable symptoms in its early stages. Without proactive screening, it can remain undetected for years. When symptoms finally appear, kidney function has often declined significantly.
Yet opportunities for earlier detection already exist.
CKD is closely associated with conditions such as diabetes and hypertension, which are routinely managed in primary care. This means the opportunity for earlier detection already exists within the system. Despite this, screening for kidney disease is not yet consistently integrated into everyday clinical practice.
This missed opportunity is particularly concerning given that CKD is already among the country’s top five causes of disease burden, alongside ischemic heart disease, stroke, and diabetes. Yet kidney damage often remains undetected until later stages, when treatment options become more complex and costly.
The cost implications are significant.
Early-stage CKD can often be managed at approximately P42,000 per year, through regular monitoring and appropriate medical management.
At this stage, the focus is on slowing progression and maintaining kidney function.
The financial gap widens dramatically as the disease advances. Research shows that direct medical costs increase approximately eleven-fold between early and advanced stages of CKD, illustrating how delayed diagnosis can quickly translate into significantly higher healthcare spending.
In contrast, costs increase substantially as the disease advances, with renal replacement therapies such as dialysis or transplantation costing over P400,000 annually in direct medical expenses alone, excluding additional non-medical and indirect costs. Care becomes long-term, resource-intensive, and life-sustaining.
This represents a several-fold increase in cost-even before accounting for indirect costs such as lost productivity and long-term care.
When viewed at a national level, this creates a pattern where more resources are naturally directed toward advanced disease. Over time, the P592 billion burden reflects this imbalance-not only in disease prevalence, but in how care is distributed across stages of illness.
Importantly, the tools for early detection are already available.
Tests such as urine albumin-to-creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR) are simple, widely recommended, and clinically validated for identifying kidney damage at an early stage. However, these tests are not yet routinely integrated into primary care screening in many settings.
At the same time, healthcare-seeking behavior tends to be reactive. Many patients only consult only when symptoms appear, often due to financial constraints, limited awareness, or lack of preventive screening opportunities. Coverage structures also tend to prioritize treatment over early diagnostics, which can further reinforce this pattern.
Taken together, these factors create a system where CKD is more likely to be identified later in its progression, even when earlier detection would have been possible.
When identified early, CKD progression can often be slowed through timely intervention, appropriate medication, and lifestyle support. This helps preserve kidney function for longer and reduces the risk of complications later on.
It also helps reduce the long-term financial burden on both patients and the healthcare system.
In kidney care, timing is not just a detail in treatment. It is often one of the most important factors in improving early detection requires making it part of routine care, especially for high-risk individuals.
This includes integrating uACR and creatinine testing into primary care check-ups, where most patients first seek care, and strengthening community health systems such as barangay health centers so screening can happen closer to communities.
Local government units (LGUs) play a key role in normalizing preventive screening, with emerging public-private collaborations already showing how community-based early detection can be both feasible and scalable.
The P592 billion burden of CKD is often understood as the result of disease prevalence.[] But a closer look shows that a significant part of this cost is shaped by late detection and late intervention.
From a clinical perspective, this is an important distinction. It means that a large portion of this burden is not fixed-it is preventable.
The Philippines now stands at a point where the question is not whether CKD can be detected earlier, but whether early detection can be made part of everyday care.
The question is no longer whether CKD can be found earlier. The question is whether we can make early detection the standard rather than the exception.
Because when kidney disease is identified earlier, patients have a greater opportunity to preserve kidney function, avoid complications, and reduce the need for costly interventions later on.
Dr. Greta Cortez is a distinguished cardiologist and critical care specialist with over 14 years of clinical experience and more than a decade of leadership in the pharmaceutical industry. She currently serves as the Head of Medicine, Human Pharma at Boehringer Ingelheim Philippines, where she has been instrumental in shaping medical strategies and advancing patient-centric healthcare solutions. In parallel with her corporate role, Dr. Cortez practices as a Cardiologist and Critical Care Specialist at Cardinal Santos Medical Center and Mary Mediatrix Medical Center, reflecting her sustained commitment to both medical innovation and frontline patient care.