This one-minute test could save your kidneys

MANILA, Philippines — January is when many Filipinos quietly resolve to take better care of themselves: eat healthier, walk more, finally book that long-postponed checkup. But health intentions often collide with everyday realities—long work hours, family obligations, and the rising cost of even basic medical care.

This year, a simple one-minute test offers a way to turn those resolutions into action.

Available for free at select drugstore branches, the urine albumin-to-creatinine ratio (UACR) test allows people to check their kidney health—often for the first time. It is a small step addressing a large, growing problem: chronic kidney disease (CKD), which typically progresses silently until treatment options become limited, expensive, and life-altering.

The year-long screening initiative aims to catch the earliest signs of kidney damage, when lifestyle changes and medical care can still slow or even prevent progression to kidney failure.

For many patients, the UACR test is usually available only in hospitals or diagnostic centers, where it can cost ₱1,500 to ₱3,500. Making it free removes a barrier that often keeps people from being tested at all—especially those managing other long-term conditions like diabetes and high blood pressure.

What the free screening looks like

The process is designed to be simple and accessible, even for first-time participants:

1. Fill out a basic form with personal and medical information
2. Have their height and weight measured to compute body mass index (BMI)
3. Undergo blood pressure checking
4. Have blood sugar levels measured
5. Submit a urine sample within one hour of collection
6. Wait about a minute for the UACR result
7. Receive advice or recommendations from a healthcare professional

The non-invasive test measures how much albumin (a type of protein) is in the urine relative to creatinine, a waste product. Healthy kidneys prevent protein leakage into the urine. When damage begins, small amounts of protein appear, signaling an early warning.

The disease that rarely announces itself

CKD is often called a “silent” illness. In early stages, most patients feel no symptoms. By the time swelling, fatigue, shortness of breath, or changes in urination appear, kidney damage is often advanced and irreversible.

“Many Filipinos, especially those with hypertension and diabetes, have no CKD symptoms until kidney damage is advanced,” said Dr. Rey Rosales of Diabetes Philippines.

A 2022 study estimated the prevalence of CKD in the Philippines at 35.94% — far above the global average of 9.1% to 13.4%. Data from the National Kidney and Transplant Institute (NKTI) show that the number of Filipinos on dialysis rose from 53,296 in 2023 to 64,845 in 2024—a 22% increase.

Dialysis centers have become a common sight, each representing a life reshaped by a disease that, in many cases, could have been slowed or prevented through early detection.

Not just an ‘older person’s disease’

Kidney disease is often associated with aging, but national data tell a different story.

More than half (57.44%) of Filipino CKD patients are between ages 20 and 59. Those aged 60 and older account for 40.82%.

Even children are increasingly affected. NKTI recorded 144 pediatric CKD cases in 2023. In 2024, that number surged to 3,031. Most cases involved boys and were linked to congenital anomalies of the kidney and urinary tract.

GRAPHIC: Ed Lustan/INQUIRER.net

Putting the scale into everyday terms, Dr. Cyril Tolosa, medical affairs director of AstraZeneca Philippines, said millions may already be affected.

“One person develops chronic kidney disease every 40 minutes, and every 60 minutes, someone with CKD progresses to dialysis,” he said.

Who is most at risk

Health experts point to key risk factors:

• Diabetes
• High blood pressure
• Heart disease
• Family history of CKD
• Obesity
• Older age
• Smoking
• Frequent use of medications that can harm the kidneys

Roughly one in three adults with diabetes and one in five with hypertension also have CKD.

In the Philippines, hypertensive nephrosclerosis causes 33.07% of cases, and diabetic nephropathy accounts for 30.04%. Both are linked to lifestyle factors such as high-sodium diets, processed food, inactivity, and weight gain.

Why early detection changes everything

The UACR test does not diagnose kidney failure but identifies early signs of kidney stress.

“Even a small amount of protein spilling from the kidneys can already be detected,” Tolosa said. “This means there is a chance that these patients will progress to dialysis because they already have chronic kidney disease—especially if the result is confirmed after repeating the test three months later.”

From 2024 to 2025, more than 44,000 Filipinos were tested. About 4% — nearly 2,000 people — received positive results, giving them a chance to seek care early.

“Early detection is the most powerful tool we have against CKD,” Tolosa said. “With early UACR detection, patients and doctors can act sooner, adjusting lifestyle, optimizing medicines, and preventing progression to kidney failure resulting in dialysis.”

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What a ‘positive’ result really means

A positive UACR result does not mean kidney failure. It signals the need for confirmation.

“If the result is positive, that is considered a positive screening—then we still have to confirm it,” Rosales said. “We ask the patient if we can repeat the same test to confirm it, at least within three months. You need to have two positive test results.”

Patients are advised to bring their results to a physician for further evaluation.

Food, weight, and everyday choices

Diet plays a key role in kidney health. Experts stress that prevention doesn’t mean abandoning Filipino cuisine.

“It’s not really about a cultural shift; it’s more about learning how to manage things, because it’s difficult to change our culture—it’s already there,” Rosales said. “You can’t change how kare-kare is prepared—when you eat kare-kare, where would the bagoong be? You also can’t cook adobo with very little soy sauce because it wouldn’t taste good.”

The focus, he said, is on moderation and awareness.

“Once we realize that what we’re eating has so much sodium or protein, we need to ask: Why would I keep eating this if I know it could harm me in the future?”

Doctors recommend reducing red meat and opting for plant-based protein sources.

“We encourage getting protein from vegetables like lentils and beans,” Rosales said.

Cost-conscious suggestions include tofu, munggo, fish, and beans—affordable and nutritious options.

Clinical dietitian Jennina Duatin also highlighted sodium intake.

“As Filipinos, we favor processed foods—our dipping sauces, gravies from fast-food meals, soy sauce, bagoong, and dried fish—but they have high sodium content,” she said.

Understanding the stages of CKD

Kidney disease progresses in stages, based on how efficiently the kidneys filter waste from the blood:

• Stage 1: Normal filtration, but early damage may already be present
• Stage 2: Slight decline in function, often without symptoms
• Stage 3a: Clear loss of function; intervention can still slow progression
• Stage 3b: Higher risk of complications
• Stage 4: Severe damage requiring close medical care
• Stage 5: Kidney failure, requiring dialysis or transplant

The earlier CKD is detected, the more treatment options are available.

Community-based screening 

UACR testing is not part of many routine physicals. It’s often prescribed only when kidney problems are suspected.

GRAPHIC: Ed Lustan/INQUIRER.net

Bringing the test into everyday community spaces helps normalize preventive screening—especially for those over 50, or with diabetes, hypertension, or a family history of kidney disease.

Free UACR testing is available at these Mercury Drug branches:

• Pavilion Mall, Mandaluyong City
• Shangri-La Plaza, Mandaluyong City
• TriNoma Mall, Quezon City
• Noveleta, Cavite

The screening is open to adults, particularly those with diabetes, high blood pressure, a family history of kidney disease, or those aged 50 and above. Participants should bring a valid ID and allow time for basic measurements and sample collection.

Health workers say locations were chosen for high foot traffic and accessibility, to reach people who may not seek hospital testing.

CKD can take years to become apparent. By then, treatment may require lifelong dialysis or a transplant. The free UACR screening does not promise instant cures. What it offers is something simpler but potentially life-changing: an early warning.