Chronic kidney disease (CKD) is a growing public health challenge in Asia, affecting over 400 million people. In an insightful discussion with BioPharma APAC, Sylvia Varela, AVP, Asia, AstraZeneca, sheds light on the pressing need for early detection, the challenges hindering CKD diagnosis, and the policy reforms required to enhance patient care. She also highlights AstraZeneca’s ongoing initiatives, including digital screening tools, nationwide risk assessment programs, and awareness campaigns aimed at mitigating CKD’s impact. As the region braces for a sharp rise in CKD cases, Varela emphasizes the urgent need for collaboration between healthcare providers, policymakers, and industry leaders to drive meaningful change in CKD management.

Q: Could you provide an overview of the current burden of chronic kidney disease (CKD) in Asia, including prevalence rates and key contributing factors unique to the region?

Chronic kidney disease (CKD) is a condition where the kidneys progressively lose function and cannot filter blood or balance the body’s fluids, salts, and minerals as well as they should. Around 10% of the global population, (850 million people), are affected by CKD and approximately half of them – 434.3 million – come from Asia. 

In Asia, this burden is further exacerbated by factors such as the rising prevalence of diabetes and hypertension, both significant contributors to the development and progression of kidney damage. In fact, Asia bears the highest prevalence of diabetes-related CKD, which can go up to 53%. 

To truly transform lives, we need governments and policymakers to recognize CKD as an urgent health priority and implement patient-centered and evidence-based policies to enable earlier detection, diagnosis and access to care to bring the best possible outcomes for patients, healthcare systems, and the economy. 

Q: What are the primary obstacles to early CKD detection in Asian countries, and how can healthcare systems overcome these barriers?

A key obstacle to early CKD detection is its asymptomatic nature at early-stage. This disease is known as ‘the silent killer’. Stage 3 CKD is the most prevalent globally and where the greatest opportunity to improve diagnosis rates and care exists, but less than 10% of people with stage 3 CKD know they have the disease. Many patients thus end up being diagnosed at advanced stages, leading to higher healthcare costs and economic strain on families and communities.

Another obstacle is the lack of adequate infrastructure to implement early detection measures. Asian countries grapple with low heath literacy, the absence of key strategies for screening programmes and multidisciplinary care, hindering the implementation and uptake of screening. In Indonesia, screening rates amongst patients with diabetes and hypertension are low despite being covered under national insurance. 

It is critical to increase awareness of the disease and establish routine screening programmes in efforts to shift the detection of CKD to earlier stages, where there is greater opportunity to improve care and prevent the progression to kidney failure. 

One way this can be done is by leveraging technology to scale screening and assessment to determine CKD risk. For example, we joined efforts with the Ministry of Public Health and the Nephrology Society of Thailand to adopt a CKD Risk Score digital tool in Thailand to identify high-risk CKD populations. The digital screening tool uses a risk assessment model for kidney disease over the next 10 years, known as the Thai CKD Risk Score. Individuals complete a 5-question survey within 1-2 minutes, which the system uses to calculate the risk score and interpret the risk into three levels: high risk, medium risk, and low risk of developing kidney disease. This digital tool already helped to identify 250,000 cases of chronic kidney disease in 2024 and will be used to screen 1 million individuals in 2025.

In Malaysia, we have also launched a web-based application tool to determine the risk of CKD progression using the Kidney Failure Risk Equation (KFRE), empowering better disease management by primary care physicians.  

Q: What initiatives is AstraZeneca implementing to prevent CKD progression and manage the disease effectively in its early stages?

AstraZeneca’s ambition is to eliminate the progression of CKD to kidney failure, by transforming CKD care to focus on increasing earlier screening, diagnosis and access to guideline-directed therapy. We cannot do this alone, and that’s why we are working closely with partners to change the future of CKD care and the impact on patients, healthcare systems and communities. 

To increase earlier screening and diagnosis in Asia, we partner with local governments. In the Philippines, we work with 18 cities and provinces to help Filipino patients access free risk assessment, micral testing and urine albumin-creatinine ratio (uACR) testing as part of CKD screening and prevention efforts. To date, close to 2 million patients have been screened in the Philippines under the ACT NOW for CKD programme. We plan to further expand this project to private organisations to intensify early detection, diagnosis and management of CKD.

Q: How important is public awareness in combating CKD, and what efforts are being made to educate communities about early detection and prevention?

Public awareness is paramount in tackling CKD, as educated communities are more empowered to take proactive steps for their health. With the interconnectedness of cardio-renal-metabolic diseases including CKD, diabetes and heart failure, we must empower individuals to recognise the risk factors, access early testing and make informed decisions about their health. In Vietnam, we are working with the Ministry of Health to reach at least half a million citizens through disease awareness and early screening activities, advocating for people to take care of their health early and enhance the quality of care available. To date, we have educated 130,000 people on Multiple Risk Factors of chronic diseases and screened 10,000 people for CKD in partnership with the Vietnam Young Physicians’ Association. In 2025, we are working to reach 240,000 and 12,000 people respectively through education and screening efforts.

 At AstraZeneca, we are committed to creating a healthier future by empowering young people to better manage their health. Through our Young Health Programme (YHP), a disease prevention programme with a unique focus on young people aged 10 to 24 living in vulnerable environments, we initiate peer-to-peer education programmes in partnership with non-profit organisation partners. This empowers young people with knowledge of risk factors contributing to non-communicable diseases (NCDs) including diabetes and heart diseases, so they can make informed choices about their health and prevent the onset of these diseases. In Asia, the YHP programme is active in China, India, Indonesia, Korea, Malaysia, Philippines, Taiwan, Thailand, and Vietnam, directly reaching more than 2.3 million young people with health information and awareness and training more than 90,000 people in NCD prevention measures.

Q: What policy changes or healthcare system improvements are necessary to better address CKD in Asia?

By 2027, the prevalence of CKD is expected to increase by up to 24% leading to increase in costs by up to 37%. Given the high burden of CKD in the region, it is more important than ever to elevate CKD as a public health priority, with a focus on early detection. Globally, more than half of 160 countries don’t have a national strategy for CKD care and, where plans exist, they are often focused on dialysis and transplantation. 

Given mounting evidence that current treatment options can effectively prevent the progression of CKD when used in earlier stages, it is imperative that healthcare systems prioritise CKD screening within populations. Beyond that, it is also key to prioritise the use of guideline-directed therapy, which can help treat underlying disease causes, relieve symptoms, slow progression, and lower the risk of related risk of CV complications, further alleviating the burden of CKD care on healthcare systems.  

Q: Looking ahead, what are the key priorities for AstraZeneca in tackling CKD in Asia over the next few years?

Along with our partners, we will continue to do our best to improve the situation with screening, diagnosis, and access to guideline-directed medical therapy in Asia. We will also advocate for healthcare systems strengthening and reform to address the unmet medical needs – from prevention to post-treatment and wellness. 

In efforts to elevate CKD as an urgent public health priority, AstraZeneca and the Global Patient Alliance for Kidney Health have co-created the Make the Change for Kidney Health campaign to enable earlier detection, diagnosis, and immediate access to care and medical guideline-recommended treatments. 

By working collaboratively with governments, healthcare providers, patient organisations, and other stakeholders, we can make significant progress in addressing the growing burden of CKD in Asia and improve the lives of millions of people affected by this debilitating disease. We must act now to make the change for kidney health.

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