NZ health services struggling to cope with rapid rise of silent killer linked to diabetes and high blood pressure

Nicky Pellegrino

Health writer·New Zealand Listener·

25 May, 2026 06:10 PM4 mins to read

‌

Subscribe to listenAccess to Herald Premium articles require a Premium subscription. Subscribe now to listen.Subscribe now

‌

SaveShare this article

Reminder, this is a Premium article and requires a subscription to read.

Copy LinkEmailFacebookTwitter/XLinkedInReddit

Renal specialist Curtis Walker describes chronic kidney disease as a growth industry. Image / Getty Images

A common disease that is known as a silent killer is on the rise worldwide. More than 550,000 New Zealanders – about one in 10 – are suffering from it, according to the Kidney Society, although many will be unaware.

We could be doing far more to stop
their health declining. “Chronic kidney disease is a growth industry, sadly,” says Palmerston North-based renal specialist Curtis Walker. “Its incidence is climbing and climbing, and what lies behind it is largely the epidemic of diabetes and high blood pressure.”

The kidneys play a vital role in our bodies by filtering waste products from our blood and regulating levels of salt, water and other chemicals in our system. Their function can worsen with age but having poor metabolic health speeds up that process, damaging the kidneys and eventually leading to their failure.

“The problem is you don’t start getting symptoms until your kidneys are functioning at around 10%,” says Walker. “By that stage it’s far too late to do anything about it other than dialysis or a kidney transplant, so that’s why it’s a silent killer.”

Māori and Pasifika face disproportionally high rates. Te Pāti Māori MP Takutai Tarsh Kemp died of kidney disease aged 50 last year while on the waiting list for a transplant.

Often, the damage begins early in life. A 2022 University of Otago study found people who grow up in deprived socio-economic conditions or are overweight in childhood are more likely to have poorer kidney function in their 30s and 40s and more at risk of developing chronic kidney disease.

Last year, 5747 New Zealanders were treated for kidney failure. With rates of the disease predicted to continue rising, Walker says we need to be doing more to prioritise prevention and early detection.

“Screening and monitoring people is key because then we can act to slow the decline in kidney function.”

Simple blood and urine tests can check for early signs of kidney damage. To keep the organs functioning in the years ahead involves a combination of medication, diet and lifestyle.

“There are some good medications that can help with this over the years,” says Walker. “If we can slow the progression of kidney disease we know it’s cost-effective for our country. We stop patients getting to the expensive end of the health system, which is dialysis and kidney transplant. And setting aside the cost, the health burden for people who have to be on dialysis is massive. It takes you out of your life and your community, and makes it very difficult to work or travel away from home. And there are also some real concerns about dialysis unit capacity.”

Walker would like to see kidney care made more of a priority in health planning. A recent survey revealed half of all renal services are operating above capacity and many patients are having to travel long distances, particularly in the South Island, where there are only three units. In March, kidney patients in Christchurch were warned dialysis might have to be rationed because of staffing shortage and lack of space in the unit.

Generally, patients with end-stage kidney disease need to be dialysed three times a week. They spend 4-5 hours at a time hooked up to a machine that filters waste products and excess fluid from the blood. Home dialysis is possible but isn’t suitable for everyone.

“It depends on your living situation,” says Walker. “If you are in a small apartment you can’t have a big machine in there. Some patients can’t manage to hook up to the machine alone. So they need to come along to a unit. The alternative, sadly, is that they’ll die.”

One positive is that an increasing number of kidney transplants are now being performed in Auckland, Wellington and Christchurch with organs from a mix of deceased and living donors.

“We did almost 200 transplants in 2024,” Walker says. “It offers a better quality of life for patients and means they don’t have to be on dialysis.”

Preventing kidney disease is obviously the ideal. That involves keeping blood sugar and blood pressure in a healthy range, staying well hydrated, not smoking, and looking after cardiovascular health with a good diet and exercise.

“If you’re concerned about your kidneys then go to your GP. Your health can be evaluated and if your kidneys aren’t 100% they can be monitored and you can act to slow the decline.”

SaveShare this article

Reminder, this is a Premium article and requires a subscription to read.

Copy LinkEmailFacebookTwitter/XLinkedInReddit