By Special Correspondent

Millions of people worldwide face a serious health risk from the combined effects of diabetes, high blood pressure, and kidney disease.

However, many remain unaware of the connection until it’s too late. Understanding how these conditions interact is crucial for reducing risk and managing them—especially for those supporting family members with these health issues.

In Kenya, diabetes is an increasing public health concern. In 2021, approximately 821,500 adults were living with diabetes, with 4% of adults affected—mostly by Type 2 diabetes, which typically develops in adulthood. Alarmingly, a significant number of cases go undiagnosed, according to the Ministry of Health.

Diabetes occurs when the body struggles to produce or use insulin, leading to elevated blood sugar levels and widespread health complications. Dr John Ngigi, head of the Nephrology and Kidney Transplant Unit at Nairobi West Hospital and chairperson of the Renal Association of Kenya, explains:

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“Diabetes affects small blood vessels, which can cause high blood pressure and lead to kidney disease.”

This creates a vicious cycle, as Dr Mohamed Hany Hafez of the African Association of Nephrology further elaborates:

“Diabetes reduces the kidneys’ ability to filter blood efficiently and causes blood vessels to stiffen, leading to high blood pressure. In turn, high blood pressure worsens kidney disease—like adding fuel to a fire. It also increases the risk of heart problems.”

The silent threat

A major challenge is that these conditions often go undetected for years.

“Most people with Type 2 diabetes don’t receive a diagnosis or begin treatment until about five years after developing the condition,” said Dr. Hafez. “High blood pressure is known as a ‘silent killer,’ and kidney disease often presents no symptoms until it reaches an advanced stage.”

In Kenya, the Kenya Renal Association estimates that 4 million people suffer from kidney disease, a number expected to rise to 4.8 million by 2030. The leading causes? Diabetic nephropathy (kidney disease caused by diabetes) and hypertensive renal disease (kidney damage due to high blood pressure).

New medications offer hope

Recent advancements in diabetes treatment offer new hope for patients.

Two innovative drug classes—SGLT2 inhibitors and GLP-1 receptor agonists—are proving to be game-changers:

• SGLT2 inhibitors help prevent blood sugar from being reabsorbed by the kidneys.
• GLP-1 receptor agonists stimulate insulin production in the pancreas.

Both drugs effectively regulate blood sugar levels and have proven benefits in reducing the risk of kidney disease, heart failure, stroke, and cardiovascular-related deaths.

Barriers to effective treatment

Despite their benefits, adoption of these drugs has been slow. Dr Ngigi attributes this to a fragmented healthcare system where patients see multiple specialists who may not coordinate treatment.

“Doctors need to communicate better,” he said. “Right now, patients visit different doctors for different problems, and their care is not always well-coordinated.”

A patient’s perspective

For Esther Nyota, a diabetes patient who recently underwent a kidney transplant at Nairobi West Hospital, doctor communication was a critical issue.

“One doctor’s treatment plan for one condition made another condition worse,” she recalled. “I had to change doctors until I found someone who considered all my health issues holistically.”

Her experience highlights the importance of patient advocacy in managing multiple chronic conditions.

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“You have to take charge of your own healthcare and ensure that all your doctors are communicating with you at the center,” she emphasized.

The role of lifestyle changes

While medication is essential, Dr Ngigi stresses that lifestyle modifications can significantly reduce the risk of complications:

• Staying hydrated
• Eating a balanced diet
• Engaging in regular exercise
• Maintaining a healthy weight

“Even losing a small amount of weight through diet and exercise can significantly lower blood sugar, blood pressure, and kidney disease risk,” he noted. “It’s not easy, but it’s possible—and it makes a huge difference.”

The way forward

With diabetes, high blood pressure, and kidney disease on the rise, early detection, coordinated care, and lifestyle changes remain essential in preventing complications and improving health outcomes.

For Kenya and the world, prioritizing public awareness, accessible healthcare, and innovative treatments could mean the difference between life and preventable disease progression.

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