The Proposed Chronic Kidney Disease Management Act in Korea: A Step Toward a National Strategy for Kidney Disease Prevention and Care

1/5Chronic kidney disease (CKD) has quietly become one of the most pressing yet underrecognized public health challenges of our time.Globally, an estimated 788 million people aged 20 years and older were living with CKD in 2023, a marked increase from 378 million in 1990 and 627 million in 2013.The global age-standardized prevalence of CKD was estimated to be 14.2% among adults [1].Consequently, CKD has become the ninth leading cause of death, the twelfth leading cause of disability-adjusted life years, and the seventh leading cause of cardiovascular mortality worldwide [1].Korea is no exception to this trend.With rapid population aging and the continuing rise of major CKD risk factors-such as diabetes, hypertension, and obesity-the burden of CKD is expected to grow further.Recent reports estimate the age-standardized prevalence of CKD among Korean adults to range from 5.5% to 10.5% in 2023 [1,2].The prevalence increases sharply with age, reaching 25.1% among individuals aged 70 years [2].The consequences of CKD progression are profound.Kidney failure, also known as end-stage kidney disease (ESKD), requires kidney replacement therapy, including dialysis or kidney transplantation.According to the ESKD Fact Sheet 2024 published by the Korean Renal Dialysis System Registry Committee of the Korean Society of Nephrology (KSN), the number of patients initiating dialysis doubled over the past decade, with incidence increasing from 9,335 patients in 2010 to 18,598 in 2022.During the same period, prevalence rose from 58,860 to 134,826 patients [3].This rapid increase has placed a substantial financial burden on Korea's healthcare system.The annual medical cost per patient undergoing hemodialysis exceeds 27 million Korean won, and national health insurance spending on dialysis treatment alone reached approximately 2.6 trillion Korean won in 2023 [4].Despite its profound impact on patients' quality of life and the escalating social, economic, and healthcare burden, CKD has historically received less policy attention than other major noncommunicable diseases.