Record kidney transplants in the Netherlands as salt intake stays high

The number of kidney transplants in the Netherlands reached a record high last year, with 1,129 procedures performed. At the same time, chronic kidney disease is on the rise, fueled by unhealthy lifestyles, excessive salt consumption, and related health conditions, Nu.nl reports. Experts warn that without intervention, the problem will worsen in the coming decades.

Figures from the Dutch Transplantation Foundation (NTS) show that kidney transplants have steadily increased over the past decade, rising from 987 in 2014 to 1,129 in 2024. This growth is driven by multiple factors, including changes in donor laws and increasing awareness, but also by a surge in kidney disease cases.

Currently, 1.8 million people in the Netherlands suffer from chronic kidney disease, with 130,000 new cases diagnosed each year, according to Annemiek Dorgelo of the Kidney Foundation. "Chronic kidney disease can lead to kidney failure, often requiring dialysis or a transplant," she said. Dialysis is a process that removes waste from the blood when the kidneys no longer function.

Transplant surgeon Cyril Moers of the University Medical Center Groningen (UMCG) warns that the problem has been worsening for decades and will continue to escalate if no action is taken. "We are heading toward the same health crisis seen in the United States," he said, referring to rising obesity, diabetes, and hypertension rates.

Reducing salt intake is one of the most effective ways to prevent kidney damage, experts say. "Eating less salt keeps kidneys healthy and can reduce the number of transplants needed," Dorgelo emphasized. The recommended daily salt intake is 6 grams—about three half-teaspoons—but most Dutch citizens consume nearly double that amount.

The National Institute for Public Health and the Environment (RIVM) found that Dutch men consumed over 11 grams of salt per day in 2021, while women exceeded 8 grams. A study by the institute estimates that cutting salt intake to recommended levels could prevent 150,000 cases of kidney disease and 250 cases of kidney failure requiring dialysis or transplantation over the next decade.

Dietitian Esther van Etten highlights that the effects of high salt consumption may be decades in the making. "We dramatically increased our salt intake years ago, and we're now seeing the consequences," she said. Moers agrees but stresses that salt is not the only culprit. "Aging, poor diets, and obesity are leading to more cases of diabetes and cardiovascular disease, both of which severely damage kidneys."

While the 2020 Donor Act, which automatically registers individuals as organ donors unless they opt out, has helped increase kidney transplants, demand still outpaces supply. As of February 2025, a record 3,416 people were on the waiting list for a kidney transplant.

Moers notes that the new law has led to more patients being placed on the transplant list, including older individuals and those with complications. "We're taking more risks than we used to, and the availability of donor kidneys has increased slightly," he said. However, many people still do not qualify for the list.

Vincent de Meijer, head of UMCG's transplant center, explains that candidates undergo a rigorous screening process. "A transplant must be medically beneficial. Patients need to be mentally stable, adhere to treatment plans, and preferably have no additional serious illnesses," he said. "Organs are scarce, and priority goes to those who will benefit the most."

Experts stress that preventing kidney disease is as important as increasing the supply of donor organs. "Encouraging healthier lifestyles is challenging and requires large-scale efforts," Moers said.

The Kidney Foundation urges people to eat fresh foods and avoid processed meals, which contain hidden salt. "Around 85 percent of our salt intake comes from packaged foods, not from the salt shaker," Dorgelo said. Van Etten agrees, noting that foods like bread and cheese already contain significant amounts of salt. "Adding processed products on top of that quickly pushes intake beyond safe levels."

In addition to prevention, advancements in organ preservation technology may help address the shortage of donor kidneys. De Meijer highlights the potential of cold and warm machine perfusion, techniques that extend the viability of donor organs. "Cold machine perfusion pumps oxygenated fluid through an organ to maintain its quality, reducing time pressure in transplant surgeries," he explained.

"Warm machine perfusion, on the other hand, allows us to test an organ’s functionality before transplantation," he added. This method has reportedly already increased the number of viable donor livers, resulting in 25 additional transplants, and is now being tested for kidneys. If successful, it could provide hope for thousands of patients waiting for a new kidney.