If we don't do anything about it, we're going to deplete our resources
In the Philippines, a quiet epidemic is overwhelming both bodies and budgets: chronic kidney disease now claims more than seven million Filipinos, adding a new patient every hour, while the national health insurer spends hundreds of millions on dialysis and transplants. At a forum in Cebu, nephrologists warned that a healthcare system treating illness after the fact cannot long endure the weight of a preventable crisis. The disease is no longer a condition of old age — it is a mirror held up to modern habits, reflecting the costs of inaction in sugar, salt, and sedentary living. The arithmetic, as one doctor put it plainly, does not lie.
- PhilHealth spent P161 million on hemodialysis in just five months at a single institute, making kidney treatment the country's single most expensive medical burden — and the bill is still growing.
- More than seven million Filipinos carry a disease that develops in silence, most unaware until their kidneys have already failed and only the most costly interventions remain.
- The crisis has shifted generations: adults aged 20 to 59 now make up 57 percent of all CKD patients, exposing lifestyle — not aging — as the true driver of the epidemic.
- Unregulated dietary supplements, amplified by social media influencers, pose a hidden and underappreciated threat, with concentrated 'natural' ingredients capable of causing the very kidney damage patients hope to avoid.
- Nephrologists are urging a national pivot toward prevention — early screening for diabetics and hypertensives, lifestyle reform, and skepticism toward unproven remedies — as the only path that does not end in system collapse.
At a media forum in Cebu, Dr. Juliet Chua Chong-Noel of the Philippine Society of Nephrology delivered a warning that was as much fiscal as medical: at the current rate of chronic kidney disease cases, the country's healthcare system will eventually break under the strain. The numbers she cited were difficult to absorb. In the first five months of 2025 alone, PhilHealth spent P161 million on hemodialysis at the National Kidney and Transplant Institute — and dialysis was already the single costliest procedure the insurer covered nationwide last year. Government benefit packages for kidney transplants now exceed P2 million per patient, with legislation pending to expand coverage further.
The scale of the disease makes these figures feel almost inevitable. Over seven million Filipinos are living with chronic kidney disease, and at least one new case is diagnosed every hour. Because the kidneys deteriorate quietly — filtering less and less waste without obvious symptoms — most patients don't learn of the damage until it is severe, by which point prevention has given way to expensive, lifelong treatment.
What sharpens the urgency is the age of those falling ill. Diabetes and hypertension, the leading causes of CKD globally, are spreading fastest among younger Filipinos. People between 20 and 59 now account for 57 percent of all registered CKD patients — surpassing seniors. This is a disease shaped by diet, inactivity, obesity, and smoking, and it is accelerating among those who should have decades of health ahead of them.
Dr. Noel also raised an underappreciated danger: unregulated dietary supplements. Unlike prescription drugs, supplements require no proof of safety or efficacy before reaching shelves. Concentrated extracts of ingredients like ampalaya can behave unpredictably — potentially toxic in high doses, ineffective in low ones, and sometimes contaminated in ways that damage the kidneys and liver. Social media influencers promoting these products with personal testimonials reach far more people than the physicians cautioning against them.
The prescription Dr. Noel offered was unglamorous but clear: control blood pressure and blood sugar, eat well, exercise, stay hydrated, quit smoking, avoid overusing painkillers and supplements, and see a doctor regularly — especially at the first sign of diabetes or hypertension. None of these are new ideas. What is new is the cost of ignoring them, now visible in every line of PhilHealth's budget.
The Philippines is running out of time and money. At a media forum in Cebu, Dr. Juliet Chua Chong-Noel, treasurer of the Philippine Society of Nephrology, laid out the arithmetic plainly: if chronic kidney disease cases keep climbing at their current pace, the country's healthcare system will simply break under the weight.
The numbers are already stark. In just the first five months of 2025, the Philippine Health Insurance Corporation spent P161 million on hemodialysis procedures at the National Kidney and Transplant Institute alone. Last year, dialysis was the single most expensive medical procedure PhilHealth paid for across the entire country. And that's only the beginning. The government is now covering kidney transplants too, with benefit packages exceeding P2 million per patient. A congressman recently filed legislation to expand coverage even further.
But the real crisis lies in the scale of the disease itself. More than seven million Filipinos are already living with chronic kidney disease. Every hour, at least one new person is diagnosed. The disease develops silently—kidneys damaged over time, losing their ability to filter waste and excess fluid—and most people don't know they have it until the damage is severe. By then, expensive interventions become unavoidable.
What makes this particularly urgent is who is getting sick. Diabetes and hypertension are the leading causes worldwide, and in the Philippines, these conditions are spreading fastest among younger adults. Data from the Philippine Renal Disease Registry shows that people aged 20 to 59 now make up 57 percent of all CKD patients, surpassing seniors. This is not a disease of aging. It is a disease of lifestyle—poor diet, sedentary habits, obesity, smoking—and it is accelerating among the young.
Dr. Noel emphasized that treatment alone cannot sustain the system. "What we want is prevention," she said. People need to see doctors before they become sick, not after. The moment someone is diagnosed with diabetes, their kidneys should be checked. Risk factors extend beyond the obvious: obesity, smoking, family history, heart disease, older age, and even being born small for gestational age all increase vulnerability.
One hidden threat has gained little public attention: unregulated dietary supplements. Unlike prescription medications, which undergo years of rigorous testing and clinical trials, supplements face minimal regulatory scrutiny. Manufacturers are not required to prove safety or effectiveness. Many people assume that because something is "natural" or sold over the counter, it must be safe. This assumption is dangerous. When ingredients like ampalaya are extracted and concentrated into pill form, their effects become unpredictable—too much can cause toxicity, too little may do nothing, and manufacturing impurities can damage kidneys and liver. Social media influencers have amplified this problem, promoting supplements with testimonials rather than science, and their reach far exceeds that of doctors warning against the practice.
Dr. Noel outlined eight rules for kidney protection: control blood pressure and blood sugar, eat well, exercise, drink adequate water, stop smoking, avoid overusing pain relievers and supplements, and get regular check-ups. These are not revolutionary ideas. They are the basics of preventive medicine. Yet they require a shift in how the country thinks about health—from waiting until crisis strikes to acting before symptoms appear. With millions already affected and many more undiagnosed, that shift cannot come soon enough.
Citas Notables
What we want is prevention. There should be more people going to doctors before they even get sick. We need to be proactive in getting check-ups.— Dr. Juliet Chua Chong-Noel, treasurer of the Philippine Society of Nephrology
The mind-set is that if it's a supplement, it's safe and has no side effects. That is not true.— Dr. Juliet Chua Chong-Noel
La Conversación del Hearth Otra perspectiva de la historia
Why is kidney disease becoming such a crisis now, rather than ten or twenty years ago?
It's not that the disease itself is new. It's that the conditions that cause it—diabetes, hypertension, obesity, sedentary lifestyles—have become epidemic. And we're not catching it early. People don't know they have kidney disease until they're already in advanced stages needing dialysis.
But dialysis exists. Isn't that solving the problem?
It's solving it for people who can afford it or whose insurance covers it. But it's unsustainable. PhilHealth is already spending hundreds of millions a year. If seven million people have the disease and most don't know it, imagine what happens when they all need treatment.
What's the connection between supplements and kidney damage? That seems like a separate issue.
It's not separate at all. People think supplements are harmless because they're not drugs. But they're not regulated the way drugs are. No one's testing them properly. And when you concentrate a natural ingredient into a pill, you lose control over the dose and purity. It's a hidden risk that most people don't even know exists.
So the real problem is that people aren't getting screened early enough?
Exactly. If someone has diabetes, they should be getting their kidneys checked immediately. If they're at risk, they should know it. Early detection changes everything. But instead, people find out they have kidney disease when they're already sick enough to need dialysis.
What would actually stop this from becoming a system-wide collapse?
Prevention. Real prevention. Not just telling people to eat better and exercise—though that matters. It's about screening programs, about making check-ups routine for people with risk factors, about stopping the supplement culture, about treating diabetes and hypertension aggressively before they damage the kidneys. It's unglamorous work, but it's the only way to avoid spending billions on dialysis.