Kidney disease in Fiji is increasingly being flagged by clinicians as a "silent killer" with many patients only discovering they have the condition once their kidneys have already failed, a specialist at Suva’s main hospital has warned.
Dr Abhitesh Raj, a kidney specialist at Colonial War Memorial Hospital (CWMH), said late detection is common and makes effective treatment far more difficult and costly. “A lot of people come to us when they have end-stage kidney disease, which means the kidney function is below 15 percent,” he said, noting that many patients only find out after routine blood tests or a kidney check reveal they have already lost most renal function.
Health experts point to the rising tide of non-communicable diseases (NCDs) in Fiji — notably diabetes and hypertension — as the main underlying drivers of chronic kidney disease. Dr Raj linked the growth in cases to unhealthy diets, lack of physical activity and limited uptake of routine health screenings, factors that allow kidney damage to progress without obvious symptoms until it becomes severe.
The scale of the problem has prompted calls for stronger early-detection measures. Australian nephrologist Dr Anis Ta’eed, who has worked with local services, stressed that timely diagnosis matters because there are medicines that can slow or stabilise kidney disease if they are started early. “Certain medicines are widely available on our Fiji essential drug list in the pharmacies, in the community, which are proven to significantly help kidney disease,” she said, underlining that access to these drugs is not the core barrier — finding patients before irreversible damage is.
Once kidney function falls below the end-stage threshold, treatment options are limited to dialysis or kidney transplant, interventions Dr Raj described as “very expensive and difficult for most patients.” Dialysis imposes a heavy financial and logistical burden on individuals and the health system, and kidney transplantation requires complex infrastructure, lifelong follow-up and immunosuppressive therapy.
This latest clinical update adds concrete thresholds and treatment realities to earlier reporting on NCDs in Fiji, which has focused on broader social and cultural drivers of conditions such as diabetes. The new emphasis from CWMH clinicians is that better population screening and earlier intervention could make existing, locally available therapies far more effective and reduce the number of patients progressing to dialysis-dependent kidney failure.
Health experts are urging practical steps: increased public awareness that kidney disease can be asymptomatic, routine kidney function screening for people with diabetes or high blood pressure, and stronger promotion of healthy diets and physical activity to reduce NCD risk. The combined message from Dr Raj and Dr Ta’eed is that the tools to curb progression exist in Fiji — the urgent task is to find affected people sooner and start treatment before kidney function drops below the 15 percent threshold.
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