South Africa faces one of the highest rates of chronic kidney disease (CKD) worldwide, driven largely by diabetes, high blood pressure, and HIV.

Yet despite the urgent need, the country has one of the lowest organ donation rates globally, just 1.2 donors per million population, according to Stella De Kock, a managing director of Transplant Education for Living Legacies (TELL) in Magaliessig.

September 1 to 5 marks the National Kidney Awareness Week, which is why TELL is shining a light on the most vulnerable patients of all: children living with chronic kidney disease.

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“For these young patients, organ donation, whether from a living donor or a deceased donor, can mean the difference between years of invasive dialysis and the chance to live a full, healthy life,” said De Kock.

She said what many people don’t realise is that you can lose up to 90% of your kidney function without showing obvious signs or symptoms.

“By the time symptoms appear, kidney damage is often severe and irreversible. The urgency is even more pronounced given the hidden health risks facing children and adults alike: Kidney risks often stay hidden.”

She said in an Eastern Cape study, 5.2% of primary schoolchildren had hypertension and 18.5% had pre-hypertension. Across Africa, rates rise with age and obesity, and South African teen cohorts show similarly high levels.

“For adults, CKD prevalence in South Africa is typically 6–9% using standard definitions, though older community studies using different methods reported higher figures (up to 24%), underscoring the need for early screening and consistent measurement.”

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She said that’s why doctors stress the importance of early detection. “Checking your blood pressure, blood glucose levels, and kidney function regularly, even in children, is vital, especially if there’s a family history of kidney failure or a chronic condition that increases risk.

Over 8 000 people in South Africa need life-saving transplants, including 40 children. Globally, children wait on average 2.5 times longer than adults for organs.

“When these silent conditions catch people off guard, families are often unprepared to make informed decisions about organ donation. Without clear knowledge of your wishes, your family may hesitate and may end up saying no.

“The truth is simple: families have the power to save lives, but they need to know what you want ahead of time.”

This National Kidney Awareness Week, TELL urges South Africans to do the following:

• Have your BP, glucose and kidney function checked – even children, especially if at-risk factors are present.
• Invite kids into the conversation. Children are waiting longer for transplants – let’s educate them early through TELL’s Orgamites Programme.
• Talk to your family about your wishes regarding organ and tissue donation.
• Consider living donation – as a parent, sibling, friend, or even an altruistic donor.
• Support TELL’s mission by purchasing a Mini Zane toy, helping fund awareness and comfort for children awaiting transplants.
• Spread the message, break the silence in schools, workplaces, and communities.

For more information, visit Tell.org.za

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