Africa’s kidney disease burden deepens as experts call for urgent action

A leading African genomics expert, Professor Segun Fatumo, has raised fresh concerns over the growing burden of kidney disease across the continent, warning that millions of lives remain at risk due to late diagnosis, limited access to treatment, and a longstanding gap in research representation.

Fatumo, who is the Professor and Chair of Genomic Diversity at Queen Mary University of London and Head of Non-Communicable Disease Genomics at the Medical Research Council Uganda Research Unit, said that although kidney disease is fast emerging as one of the leading causes of death globally, it continues to receive inadequate attention compared to other major illnesses.

According to him, about 850 million people worldwide are currently living with some form of kidney disease, more than those affected by diabetes and cancer combined, while chronic kidney disease accounts for approximately 1.5 million deaths annually.

He noted that the condition often progresses silently, with few or no symptoms until it reaches an advanced stage.

“By the time many patients present at hospitals, the disease has already caused significant damage,” Fatumo said, stressing the need for early detection and preventive care.

Fatumo highlighted that people of African ancestry are up to five times more likely to develop severe kidney failure compared to those of European descent, placing Africa at the centre of the global crisis.

He attributed this to a combination of genetic predisposition and environmental factors, including the rising prevalence of hypertension and type 2 diabetes across sub-Saharan Africa, a situation that is further compounded by weak health systems.

“There is a critical shortage of kidney specialists, dialysis centres and transplant services across much of Africa. For many patients, there is simply no access to life-saving care,” he said.

The experts said kidney disease typically develops gradually, being influenced by both inherited genetic factors and environmental exposures such as poor diet, untreated high blood pressure, infections, harmful substances and certain herbal and traditional remedies.

He decried African populations having been underrepresented in global genetic studies, limiting the effectiveness of diagnostic tools and treatments for decades.

Fatumo explained that over 85 per cent of participants in large-scale genomic research have been of European ancestry, creating a gap that has real clinical consequences.

“Risk prediction tools built on non-African data often perform poorly when applied to African populations. They can miss real risks or give misleading results,” he said.

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The don, however, explained that a new study by the KidneyGen Africa consortium is seeking to address this imbalance.

He declared that the KidneyGenAfrica consortium had analysed genomic data from more than 110,000 individuals, including participants from across Africa and those of African ancestry in the diaspora, making it the largest study of kidney function in continental Africans to date.

According to him, using advanced genome-wide analysis, the team identified multiple genetic regions associated with kidney function, including several previously unknown variants.

Fatumo said the findings represent a significant step towards improving diagnosis and treatment.

“Each discovery opens new possibilities for developing targeted therapies and more accurate diagnostic tools,” he noted.

Fatumo added that the study also examined the role of the APOL1 gene variant, a gene previously linked to increased kidney disease risk among African Americans, and found that its contribution to kidney disease risk appears to be modified by environmental and biological context and may not operate in the same way in continental African populations as it does in African Americans. Its impact is weaker and less prevalent in continental African populations.

He explained that these findings indicated that genetic risk factors may vary depending on environmental and biological context, raising important questions for treatment strategies.

“It is scientifically unjustifiable to assume that findings from African American populations can be directly applied to Africans living on the continent,” Fatumo said.

Fatumo, therefore, called for expanded access to early screening through simple blood and urine tests, greater inclusion of African populations in clinical trials and increased investment in healthcare infrastructure and genomic research.

He said that early detection remains the most effective way to reduce the burden of kidney disease.

“If identified early, kidney disease can be managed through lifestyle changes and medication, preventing progression to kidney failure,” he said.

Fatumo maintained that sustained investment in research infrastructure and collaboration is essential to ensure that scientific advances translate into improved health outcomes.

“Africa must not only participate in global research, but it must also lead in areas that directly affect its populations,” he added.