Why Managing Obesity Matters For Kidney Health

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Letter to Editor
FOOD is central to life in Malaysia, from nasi lemak to late-night teh tarik. However, a health crisis looms over this vibrant culinary culture.
The National Health and Morbidity Survey (NHMS) 2023 reports that 54.4% of Malaysians are overweight or obese, with over 2 mil affected by noncommunicable diseases (NCDs) like diabetes and hypertension.
Studies have showed that obesity increases the risk of developing low eGFR and albuminuria, which are both features of chronic kidney disease.
In Malaysia, 56% of new dialysis cases arise from diabetes, followed by hypertension at 30%, according to the Malaysian Dialysis and Transplant Registry 2023, highlighting a concerning health concern of kidney disease.  
Professor Dr Wong Hin Seng warns that obesity doesn’t just lead to diabetes or high blood pressure. It independently damages the kidneys, even in people without those conditions.
“The kidneys are like the body’s natural filters, removing waste and excess fluids, regulating blood pressure, and balancing electrolytes to keep everything running smoothly. However, these finely tuned organs can be overwhelmed by excess weight,” he said.
Obesity seriously harms kidneys, damage may be permanent
Obesity poses risks beyond diabetes and hypertension—it silently damages kidneys, often with devastating consequences.
According to Wong, obesity can strain the kidneys through chronic inflammation, oxidative stress, increased blood pressure, and insulin resistance.
These effects can lead to protein leakage in the urine, an early sign of kidney damage.
“Obesity can increase the risk of chronic kidney disease (CKD) and accelerate its progression. When the kidneys are under constant stress, they fail faster,” he said.
For those already struggling with obesity, kidney disease can remain undetected for years. By the time symptoms appear, such as swelling or fatigue, it’s usually too late to reverse the damage.
Young Malaysians at Risk: Early Kidney Damage
Younger Malaysians are increasingly affected by obesity-related kidney damage. The NHMS 2023 study also showed that 84% of adults aged 18 -24 do not know that they have diabetes.
“If you’re obese since childhood or in your teens, the negative impact of obesity to your kidneys can start from then and may already be facing with chronic kidney disease when you are in your 30’s–40’s,” said Wong.
This early onset of kidney disease disrupts the most productive years of life and places significant strain on the families, the healthcare system and the nation.
However, 2 in 5 adults aged 18-24 have not undergone health screening in the past 12 months.
Furthermore, advanced CKD (stage 4 and stage 5) often leads to complications such as limited physical activities, affecting one’s mental health, and reduced quality of life.
Living with damaged kidneys is a daily challenge. It is not just about surviving. It is about losing the ability to enjoy life fully.
Unhealthy Habits Fueling Obesity
The concerning rise in obesity rates in Malaysia can be traced back to major changes in dietary habits and lifestyle choices.
Once rich in fiber and wholesome ingredients, traditional diets have increasingly been replaced by a greater dependence on processed foods and sugary drinks.
This change also coincides with a decline in physical activity, as many children and adults have adopted more sedentary lifestyles.
“Kids used to play outside—football, cycling, running around. Now, screens dominate their lives, and adults are less active, spending hours in front of computers or TVs,” Wong said.
Additionally, Malaysia’s round-the-clock food culture is also a contributing factor to the issue. Food is available 24/7 here.
“If you’re tempted to eat at midnight, you can find a meal, and young adults are working long hours where convenience trumps nutrition when it comes to food,” Wong said.
Fighting Obesity and Kidney Damage
Early action against obesity can help prevent kidney disease, the earlier, the better. Healthy eating habits and healthy lifestyle must start early.
Families must focus on balanced diets and encouraging kids to stay active from a young age. For those already dealing with obesity, small, consistent changes can protect kidney health. Swapping processed foods for fiber-rich options, reducing sugar, and staying active are essential.
“Cutting back on sugar isn’t an overnight fix. Your taste buds need time to adjust, but you’ll crave less sweetness over time,” said Wong.
While obesity’s link to diabetes and hypertension is well-known, its impact on other aspects of kidney health is not.
Obesity has been associated with increased risk of kidney stones and increased risk of developing various types of cancer including kidney cancer.
Regular health screenings are important, as kidney function and urine protein tests can detect problems early, especially for those who are overweight or diabetic.
Professor Dr Wong Hin Seng is a consultant nephrologist and kidney transplant Physician at Sunway Medical Centre, Sunway City
The views expressed are solely of the author and do not necessarily reflect those of  MMKtT.
- Focus Malaysia.

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