Bermuda has one of the highest ratios of chronic kidney failure in the world - with 67 people currently receiving dialysis treatment.

Some 16 people are on a kidney transplant waiting list and are among those attending the dialysis unit every week.

And the number of people suffering kidney failure on the Island is increasing at such an alarming rate, two weeks' ago five new patients began receiving dialysis within just seven days.

Dr. Beresford Swan, who was director of the Island's dialysis unit for 30 years, said compared to the international average, Bermuda was way above the norm.

He said the average elsewhere was for between two and four people per every 100,000 of the population to suffer serious kidney failure each year. However, Bermuda, which has a population of about 62,000, averages between six and eight people a year.

Dr. Swan said he did not know if the figures were so high because Bermuda was small and able to keep very accurate figures, as opposed to larger countries.

But he said no matter what the reason, Bermuda's record was not a healthy one. He said: "We have 67 people on dialysis at the moment and that's an awful lot for a community this size.

"I don't know another island population that has that many. Whether that's down to economic reasons, where countries don't have the money to treat them, I don't know. "But I know that between six and eight people a year for us is a lot.

"About 80 percent of our kidney failure population is due to diabetes and high blood pressure."

He said diabetes could be inherited and passed on through families, but it was largely a lifestyle problem.

He preferred to consider diabetes as a familial condition. He said it was not necessarily inherited, but if all members of the same family were keeping the same diet and living the same kind of lifestyle, they could each develop it. He said high blood pressure was not so lifestyle based, but called for more public awareness about both diabetes, and in particular high blood pressure, to ensure that conditions are brought under control at the earliest opportunity.

And he urged people to get checked out.

He said: "High blood pressure in Bermuda is the number one risk for heart attacks, strokes and kidney failure. It does not have any symptoms, so you could have high blood pressure and never even know it. "It's not called the silent killer for no reason."

Dialysis community educator Kathy Albuoy said the problem of kidney failure, for whatever reason, was definitely getting worse.

She said: "The week before last, we had five new patients start on dialysis. Normally, it does not happen like that. Right now our numbers are going absolutely crazy."

Nurse Marianne Herbert, who is the renal transplant coordinator at the Island's only dialysis unit, said she saw too often the effects of uncontrolled diabetes and high blood pressure.

She said both conditions could be passed on genetically, so in a country as small as Bermuda, it was easy for the numbers to escalate.

But she said that with early detection, and regimented treatment and diet, the conditions may never lead to kidney failure at all.

"Bermuda has a very high incidence of high blood pressure and diabetes, which can cause great problems further on in life," said Ms. Herbert.

"We have one of the highest incidence of kidney failure in the world. It is very bad. "If there is a history of either of the conditions in the family, it's essential for family members to get checked if they want to stay out of trouble.

"It's a shame if serious problems arise purely because the signs were not acted upon or checks have not been carried out."

She said kidney failure could affect people of all ages, but rarely people under the age of 20.

However, two teenagers in Bermuda have previously had to undergo kidney transplants - one was only 11 at the time.

And although diabetes and high blood pressure are the main causes in Bermuda, there are many reasons why kidney failure may arise. Conditions that affect the immune system, such as Lupus, and other infective diseases of the kidney tissue, can lead to serious problems.

She said although people in Bermuda required a variety of different major transplant operations, it was kidney transplants that were most needed.

But director of the dialysis unit, Dr. Martin Gregory, said if people acted now, they may never have to even consider dialysis or a transplant.

He said: "Dialysis is a very effective way of replacing kidney function, but its vastly better never to have to get to that point.

"The most common reason for people in Bermuda getting dialysis is uncontrolled blood pressure and diabetes. "Many of the people who come here have been receiving treatment for high blood pressure and diabetes, but many of them have not been achieving low enough blood pressure and blood sugar levels to reduce the risk as far as it could go.

"We have recently learned that we can actually slow up the development of kidney disease substantially by strict attention to getting blood pressure really low and also by taking control of blood sugar.

"The degrees of control that would have been considered perfectly acceptable a few years' ago, do not protect nearly as well as lower levels.

"Therefore, people who suffer should get regular checks and should monitor their levels at home."