The head of a clinic in American Samoa says treatment for kidney disease is becoming a huge economic drain on the territory.
160 patients are on dialysis at the LBJ hospital several times a week, receiving treatment for end-stage kidney failure.
Two major causes of chronic kidney disease are diabetes and high blood pressure, both non-communicable diseases.
The head of the Veterans Affairs Clinic, Fred Uhrle, says such diseases contributed to the deaths of more than half the people who died in 2012 and 2013.
He says accurate data and diagnosis is needed to combat the number of people dying from chronic kidney disease.
"It is a major public health problem, not only from the direct cost as you can see, of providing care for these patients, but the loss of productivity to the health workers that no longer can work because they're hooked up to the dialysis machine."
Dr Uhrle says treatment for chronic kidney disease consumes a disproportionate share of healthcare dollars.
"We're increasing our dialysis beds. Should we be proud of that? No. We need to figure out how we can stop having to increase. And despite dialysis, our outcomes are not very good. People don't really don't live that much longer and their lives are cut short, even though we're spending all this money on dialysis."
Dr Uhrle says health officials need to identify the disease early, so they can prevent it's progression.
