Chronic Kidney Disease (CKD) is often referred to as a “quiet disease” because it progresses silently until significant damage has occurred. Globally, women develop CKD at a slightly higher rate than men—11.8% versus 10.4%—and in Malaysia, this gender gap persists, with a prevalence of 14% in women compared to 12% in men. Dr. Rosnawati Binti Yahya, Consultant Nephrologist and Kidney Transplantation Physician at Sunway Medical Centre, explains that this difference is not always obvious in everyday clinical practice, as most CKD cases are driven by metabolic conditions like diabetes and hypertension, which affect both genders similarly.
Indeed, metabolic conditions remain the leading cause of CKD, accounting for up to 86% of cases in kidney centres. In Malaysia, diabetes and hypertension are responsible for 56% and 30% of kidney failures, respectively, damaging kidneys silently over years without obvious signs. This often results in delayed diagnosis, with many patients only discovering CKD when kidney function is critically impaired and dialysis becomes necessary. Dr. Rosnawati stresses the importance of early screening, as the first three stages of CKD are typically asymptomatic.
Women are also more susceptible to autoimmune-related kidney conditions, such as lupus nephritis, a complication of systemic lupus erythematosus (SLE). SLE affects women far more than men, with a female-to-male ratio of 9:1, and can lead to severe kidney damage. Compounding the risk, CKD symptoms are often subtle and easily misinterpreted. Persistent fatigue, lethargy, frequent nighttime urination, and swelling in the legs or face may be dismissed as hormonal changes, stress, or ageing. Blood tests, particularly creatinine levels, may also mislead women due to lower muscle mass, potentially masking early kidney issues.
Certain life stages increase women’s long-term kidney risk. Pregnancy complications like preeclampsia and gestational diabetes raise the likelihood of hypertension and proteinuria later in life, while menopause reduces oestrogen protection, accelerating kidney decline. Conditions like polycystic ovary syndrome (PCOS) further heighten risk through insulin resistance, obesity, and metabolic syndrome, contributing to diabetes and high blood pressure early in life. Dr. Rosnawati recommends annual monitoring of blood pressure and blood sugar, emphasizing that normal results at one stage of life do not eliminate future risk.
Early detection is key. Simple tests—a kidney function blood test, a urine protein test (albumin-to-creatinine ratio), and regular blood pressure checks—can identify CKD before irreversible damage occurs. Protein in urine is one of the earliest warning signs, yet many standard dipstick tests miss it. Early diagnosis enables timely intervention, slowing kidney decline significantly. As Dr. Rosnawati explains, even reducing kidney decline from 10% per year to 2% could prevent many patients from ever needing dialysis.
CKD develops quietly, often without warning. Women, who often care for others, must prioritize their own health. Regular screenings and early intervention are essential, even when no symptoms are present. “Even if you feel fine, get checked. If your blood tests are ‘normal’ but something still feels off, ask your doctor about your kidneys,” urges Dr. Rosnawati. By understanding risks, monitoring key health indicators, and taking preventive measures, women can protect their kidney health and ensure long-term wellbeing.
