Kidney diseases are often silent but deadly – progressing unnoticed until advanced stages. With over 850 million people affected globally, these conditions pose a growing challenge for insurance including underwriting. As populations age and chronic conditions rise, understanding how to detect and assess renal risks early becomes essential. This Quick Read explores five key insights from the recent renal updates to the PAR, PartnerRe’s life underwriting manual, designed to help underwriters assess kidney-related risks with greater clarity, speed and confidence.
Kidney diseases, including chronic kidney disease (CKD), glomerulonephritis, and kidney stones, affect up to 12% of the global population[1] . Often asymptomatic, they are frequently undiagnosed at the time of insurance application. This silent progression can lead to underestimated risks and missed opportunities for accurate underwriting.
Figure 1: The illustration shows that globally, chronic kidney disease (CKD) death rates, adjusted for age differences, have increased steadily from 1990 to 2019. Age-adjusted rates are calculated as if every country had the same age distribution. Source : Bikbov B. (Scientific-Tools.Org). Core regional metrics of chronic kidney disease (CKD) mortality in the GBD 2019 Study. Zenodo. DOI https://doi.org/10.5281/zenodo.8312914
Aging populations and rising rates of hypertension and diabetes are fueling a surge in CKD diagnoses. For example, in Germany, CKD prevalence among those aged 40+ rose from 4.4% in 2013 to 7.1% in 2022[2]. These trends highlight the need for proactive risk detection and updated underwriting practices.
Impaired renal function markedly elevates the risk of severe cardiovascular complications – two conditions that are deeply interconnected yet often underrecognized or misattributed. This complex interplay, coupled with the typically silent progression and age-related decline in kidney function, reinforces the critical role of renal health in underwriting. It highlights the need for clear, consistent guidance to ensure accurate risk assessment and sound decision-making.
Recent therapies – such as SGLT2 inhibitors and GLP-1 receptor agonists – offer promising outcomes by slowing CKD progression and reducing cardiovascular risk. These recently introduced drugs protect the kidneys by reducing stress and inflammation, improving blood flow and reducing the workload of damaged kidney tissue. This slows the progression of the disease in both the kidneys and the blood vessels. Advances in transplantation, immunosuppressive therapy, and donor matching have also improved survival rates.
Kidney conditions range from benign to complex, and distinguishing between them is a daily underwriting challenge. The PAR manual simplifies this by offering clear, practical guidance. It provides:
Pop-up medical help assists you in achieving consistent underwriting decisions and empowers even junior underwriters to make confident, high-quality decisions. The updated renal section naturally also reflects recent medical advances – such as improved transplant outcomes through enhanced immunosuppressive therapies, donor matching and viral surveillance – helping underwriters stay aligned with evolving clinical realities.
Want to learn how the PAR, our life underwriting manual, can help your company better assess and manage kidney disease risks? Contact us to discover how the PAR’s practical guidance and up-to-date medical insights can support your team in making confident, high-quality underwriting decisions.
Dr. Achim Regenauer, Chief Medical Officer Europe & Asia Pacific
[1] Prevalence trends of diagnosed chronic kidney disease and dialysis use in Germany 2017 to 2021. https://www.versorgungsatlas.de/fileadmin/ziva_docs/146/VA-24-03-Abstract_Pravalenz_Nierenkrankheiten_Endversion.pdf
[2] Chronic kidney disease and the global public health agenda: an international consensus, Nature Reviews Nephrology. https://www.nature.com/articles/s41581-024-00820-6