The global, regional, and national patterns of change in the burden of chronic kidney disease from 1990 to 2021.

Abstract

Background: Chronic kidney disease (CKD) is a major global public health problem with increasing prevalence and a huge health and economic burden. Diabetes mellitus and hypertension are major risk factors for CKD, and CKD is associated with cardiovascular disease and end-stage renal disease. Understanding the prevalence and burden of CKD is essential for the development of prevention and control strategies.

Methods: Using data from the Global Burden of Disease Study (GBD) 2021 study, this study analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) of CKD at global, regional, and national levels between 1990 and 2021. Decomposition analysis, health inequalities and frontier analysis were used to analyse the changes.

Results: This study analyzed the global regional and national burden, trends, and disparities of CKD from 1990 to 2021 and found that the global burden of CKD had increased significantly, in line with trends in population ageing and population growth, and with significant variations between regions. There were 673.7 million people with CKD worldwide in 2021, accounting for 8.54% of the global population, a 92.0% increase from 1990. Despite a slight decline in age-standardized prevalence rate (ASPR), the absolute number of CKD cases increased. Central Asia had the highest prevalence of CKD, while Central Latin America had the highest rate of DALYs and incidence for CKD. In 2021, At the national level, China had the highest number of new CKD cases. The country with the highest ASPR and age-standardized DALYs rate (ASDR) of CKD was Mauritius. Globally, age-standardized incidence rate (ASIR) and ASDR were on the rise in almost all countries/regions, suggesting that the impact of CKD on global health is increasing. Population growth and ageing were major factors contributing to the increasing burden of CKD, especially in China and low Socio-demographic Index (SDI) regions. In addition, the cross-national study of health inequalities in CKD showed that, although there have been improvements in global health over time, health inequalities continue to exist. The frontier analysis revealed a considerable degree of heterogeneity in the effective differences across the spectrum of socio-demographic indices.

Conclusion: CKD is a global health problem, the burden of which varies between regions and countries. A multifaceted approach is necessary to prevent and control CKD, including population-level interventions targeting risk factors, improvements in the accessibility and quality of health care, and measures to address health inequalities.