The Hidden Health Crisis: Why 9 in 10 People Don't Know They Have Kidney Disease

Millions of Americans have a serious health condition that could lead to heart disease or stroke, yet they have no idea it exists. According to the Centers for Disease Control and Prevention, as many as 9 in 10 adults with chronic kidney disease do not know they have it. This silent epidemic is particularly dangerous because kidney disease, diabetes, and heart disease are deeply interconnected—having one condition dramatically increases your risk of developing the others.

Why Are So Many Cases Going Undiagnosed?

The problem isn't that kidney disease is rare. Rather, it's that most people—and even some healthcare providers—don't realize kidney health is essential to heart health. According to the American Heart Association's 2026 statistics update, the issue stems from a lack of routine screening. Specifically, two-thirds of patients with high blood pressure or diabetes are unaware they also have kidney disease simply because they haven't received a urine test called uACR (urine albumin-to-creatinine ratio), which measures kidney function.

The situation extends beyond kidney disease alone. The American Heart Association reports that almost 1 in 4 U.S. adults with diabetes are unaware they have it. When these three conditions—heart disease, kidney disease, and diabetes—go undetected, they create what doctors call cardiovascular-kidney-metabolic (CKM) syndrome, a dangerous combination that significantly raises the risk of disability and death from heart disease and stroke.

What's the Connection Between Your Heart, Kidneys, and Metabolism?

Your heart, kidneys, and metabolic system (how your body creates, uses, and stores energy) are far more connected than most people realize. These three systems share common risk factors, including high blood pressure, high cholesterol, high blood sugar, excess weight, and reduced kidney function. When one system fails, it puts stress on the others, creating a domino effect of health problems.

The medical term for this interconnection is cardiovascular-kidney-metabolic syndrome, or CKM syndrome. The biggest health threats from CKM syndrome are disability and death from heart disease and stroke. Understanding this connection is crucial because it means preventing or managing one condition can help protect the others.

Which Screening Tests Should You Ask Your Doctor About?

If you have diabetes or high blood pressure, the American Heart Association recommends two specific screening tests to assess your kidney health:

• uACR Urine Test: This test measures albumin (a protein) in your urine, which indicates whether your kidneys are filtering waste properly. It's a simple, non-invasive screening that can be done during a routine office visit.
• eGFR Blood Test: This blood test estimates your glomerular filtration rate, which measures how well your kidneys are filtering waste from your blood. Each test measures different aspects of kidney health and function.
• Hemoglobin A1c Test: If you're concerned about diabetes risk, ask your doctor about this yearly blood test, which reflects your average blood sugar over the past 2-3 months and can help identify prediabetes or diabetes early.

The good news is that these tests are straightforward and often covered by insurance. If you have risk factors like high blood pressure, diabetes, obesity, or a family history of kidney disease, ask your primary care provider about getting screened.

What Can You Do Right Now?

"We are encouraging people to become aware of the connection between conditions so they and their health care team can think about their overall health beyond individual conditions," explains Dr. Stacey E. Rosen, volunteer president of the American Heart Association. "Understanding the connection helps you better prevent complications through lifestyle changes and appropriate treatment."

The first step is scheduling a conversation with your doctor. If you have high blood pressure or diabetes, request the uACR and eGFR tests. These simple screenings can catch kidney disease before it causes serious damage. Beyond testing, the American Heart Association's Life's Essential 8 framework provides actionable steps to protect your heart, kidneys, and metabolic health simultaneously:

• Eat Better: Focus on whole, unprocessed foods including vegetables, fruits, lean protein, seeds, and nuts. Use olive or avocado oil for cooking.
• Be More Active: Aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week to support cardiovascular and kidney function.
• Manage Your Weight: Carrying excess weight strains the heart and kidneys. Work with your primary care provider to set a healthy weight goal tailored to your individual health needs.
• Control Cholesterol and Blood Sugar: Regular blood work helps identify elevated cholesterol and blood sugar levels before they damage your blood vessels and organs.
• Manage Blood Pressure: Your blood pressure should be less than 120/80 mm Hg. If it's higher, work with your healthcare provider on a plan to lower it.

The reality is sobering: millions of Americans are walking around with undiagnosed kidney disease that's silently increasing their risk of heart attack and stroke. But the solution is simple. A conversation with your doctor and two basic screening tests could reveal whether you're at risk—and give you the chance to take action before serious damage occurs. Don't wait for symptoms. Ask about kidney screening today.