Addressing underdiagnosis of chronic kidney disease in Kazakhstan: a public health perspective

Chronic kidney disease represents a growing public health challenge in Kazakhstan, yet a substantial proportion of cases remain undiagnosed. National registry data suggest lower recorded prevalence compared with global estimates, while local epidemiological studies indicate that many individuals live with impaired kidney function without awareness of their condition. Late diagnosis limits opportunities for early intervention, contributes to adverse clinical outcomes, and increases long-term healthcare costs, particularly when patients progress to end-stage kidney disease. Although Kazakhstan has strengthened prevention and early detection of several non-communicable diseases through primary healthcare services, chronic kidney disease is not currently included as a dedicated condition within national screening programs and is largely detected through opportunistic testing. This perspective examines key barriers to systematic chronic kidney disease detection, including laboratory requirements, geographic dispersion, rural - urban disparities, workforce constraints, and low public awareness. Drawing on international evidence, the paper discusses potential approaches to improve early detection that are compatible with national health system capacity. A phased, risk-stratified strategy integrated into existing primary care and chronic disease management pathways may offer a feasible starting point. Complementary delivery models, including point-of-care diagnostics and community-based outreach services, could further expand access in underserved regions. Context-specific economic and implementation research is needed to guide sustainable policy decisions and optimize screening strategies.