The US, New Zealand and other developed countries faced an approaching obesity epidemic and a projected big rise in type 2 diabetes would increase kidney damage, Prof Sands said in an interview.
About 40% of kidney failure in the US was linked to diabetes, he said.
Prof Sands, who is a professor of medicine and physiology at the Emory University School of Medicine in Atlanta, Georgia, is the Community Trust of Otago Visiting Professor at the University of Otago this week.
He will give a public lecture at the Colquhoun Lecture Theatre, Dunedin Hospital, at 4pm today on the role of aquaporins-water channels- in renal disorders.
Researchers say up to one in seven New Zealanders may have renal disease.
Patients with chronic kidney disease (CKD) have a six-fold increase in cardiovascular death, and diabetics with CKD have a 20-fold increase in cardiovascular death compared with the healthy population.
Prof Sands said the extent of kidney disease had previously been underestimated, and the CKD rate in this country could be as high as one in 10.
No "miracle cure" was in sight, but controlling blood sugar and blood pressure, encouraging weight loss, increasing exercise and giving up smoking all produced significant benefits.
New Zealand's publicly-funded health system, which provided universal coverage, was better able to increase kidney-related education among patients and provided more affordable medication than in the US, he said.
By contrast, an estimated 50 million Americans are not covered by health insurance.
A renal clinic run in Dunedin by Prof Robert Walker, of the Otago medical and surgical sciences, showed the benefits arising from better drug treatment as well as improved diet and exercise, Prof Sands said.
Associate Prof John Leader and Dr Jenny Bedford, and other Otago University scientists, had also been contributing significantly to kidney research.
Prof Zoltan Endre, at Otago's Christchurch campus, and Prof Walker were also working to identify potential biomarkers in urine, which could lead to earlier disease diagnosis, Prof Sands said.
