Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023
- Patrick B Mark, Lauryn K Stafford, Morgan E Grams, Hasan Aalruz, Samar Abd ElHafeez, Ahmed Abdelrahman Abdelgalil, Rizwan Suliankatchi Abdulkader, Hansani Madushika Abeywickrama, Olugbenga Olusola Abiodun, Dmitry Abramov, Mohammed Mehdi Abrar, Lucas Guimarães Abreu, Bilyaminu Abubakar, Salahdein Aburuz, Isaac Yeboah Addo, Oyelola A Adegboye, Nurudeen A Adegoke, Temitayo Esther Adeyeoluwa, Qorinah Estiningtyas Sakilah Adnani, Bright Opoku Ahinkorah, Sajjad Ahmad, Khabir Ahmad, Ali Ahmadi, Amir Mahmoud Ahmadzade, Ayman Ahmed, Aram Mahmood Ahmed, Nesredin Ahmed, Shahzaib Ahmed, Syed Anees Ahmed, Marjan Ajami, Mohammadreza Akbari, Oluwasefunmi Akeju, Mohammed Ahmed Akkaif, Salah Al Awaidy, Hanadi Al Hamad, Syed Mahfuz Al Hasan, Yazan Al Thaher, Ziyad Al-Aly, Fahmi Y Al-Ashwal, Mohammed Albashtawy, Shereen M Aleidi, Ali M Alfalki, Fadwa Naji Alhalaiqa, Khalid A Alhasan, Endale Alemayehu Ali, Rafat Ali, Syed Shujait Ali, Syed Yusuf Ali, Samah W Al-Jabi, Mohammed Z Allouh, Wesam Taher Almagharbeh, Omar Almidani, Khaldoon Aied Alnawafleh, Najim Z Alshahrani, Awais Altaf, Nelson Alvis-Guzman, Yaser Mohammed Al-Worafi, Karem H Alzoubi, Adel Sharaf Al-Zubairi, Masoud Aman Mohammadi, Hubert Amu, Filippos Anagnostakis, Abhishek Anil, Anayochukwu Edward Anyasodor, Geminn Louis Carace Apostol, Walter Appati, Sulaimon O Araromi, Aleksandr Y Aravkin, Johan Ärnlöv, Jesu Arockiaraj, Bernard Kwadwo Yeboah Asiamah-Asare, Yuni Asri, Ashagre Molla Assaye, Maha Moh'd Wahbi Atout, Khursheed Aurangzeb, Adedapo Wasiu Awotidebe, Sadat Abdulla Aziz, Domenico Azzolino, Muhammad Badar, Mohamad Amin Bakhshali, Shoshana H Ballew, Ovidiu Constantin Baltatu, Maciej Banach, Mainak Bardhan, Hiba Jawdat Barqawi, MD Abu Bashar, Shahid Bashir, Mohammad-Mahdi Bastan, Saurav Basu, Neeraj Bedi, Bekalu Mekonen Belay, Makda Abate Belew, Aminu K Bello, Luis Belo, Amiel Nazer C Bermudez, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Ajay Nagesh Bhat, Priyadarshini Bhattacharjee, Jasvinder Singh Bhatti, Gurjit Kaur Bhatti, Sibhatu Kassa Biadgilign, Yacong Bo, Trupti Bodhare, Archith Boloor, Hamed Borhany, Michael Brauer, Raffaele Bugiardini, Akeem Olayinka Busari, Yasser Bustanji, Luis Alberto Cámera, Luciana Aparecida Campos, Ismael Campos-Nonato, Juan Jesus Carrero, Márcia Carvalho, Alberico L Catapano, Monica Cattafesta, Muthia Cenderadewi, Edina Cenko, Deepak Chandramohan, Vijay Kumar Chattu, Lam Duc Chau, Anis Ahmad Chaudhary, An-Tian Chen, Haojin Cheng, Nicholas WS Chew, Patrick R Ching, Hou In Chou, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Dinh-Toi Chu, Sheng-Chia Chung, Alyssa Columbus, Paolo Angelo Cortesi, Karen Courville, Natalia Cruz-Martins, Omid Dadras, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Saswati Das, Tadesse Asmamaw Dejenie, Vinoth Gnana Chellaiyan Devanbu, Devananda Devegowda, Syed Masudur Rahman Dewan, Mandira Lamichhane Dhimal, Meghnath Dhimal, Daniel Diaz, Huyen Phuc Do, Thao Huynh Phuong Do
- https://doi.org/10.1016/S0140-6736(25)01853-7
Summary
Background
Chronic kidney disease (CKD) is common and ranks among the leading causes of mortality and morbidity. This analysis aimed to present global CKD estimates using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to inform evidence-based policies for CKD identification and treatment.
Methods
This analysis focused on adults aged 20 years and older over the period 1990 to 2023, from 204 countries and territories. Data sources used were published literature, vital registration systems, kidney failure treatment registries, and household surveys. Estimates of CKD burden, including deaths, incidence, prevalence, and disability-adjusted life-years (DALYs), were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool. A comparative risk assessment approach estimated the proportion of cardiovascular deaths attributable to impaired kidney function and estimated risk factors for CKD.
Findings
Globally, in 2023, 788 million (95% uncertainty interval 743–843) people aged 20 years and older were estimated to have CKD, up from 378 million (354–407) in 1990. The global age-standardised prevalence of CKD in adults was 14·2% (13·4–15·2), a relative rise of 3·5% (2·7–4·1) from 1990. The region with the highest age-standardised prevalence was north Africa and the Middle East (18·0%; 16·9–19·4). Most people had stage 1–3 CKD, with a combined prevalence of 13·9% (13·1–15·0). In 2023, CKD was the ninth leading cause of death globally, accounting for 1·48 million (1·30–1·65) deaths, and the 12th leading cause of DALYs, with an age-standardised DALY rate of 769·2 (691·8–857·4) per 100 000. Impaired kidney function as a risk factor accounted for 11·5% (8·4–14·5) of cardiovascular deaths. High fasting plasma glucose, body-mass index, and systolic blood pressure were all leading risk factors for CKD DALYs.
Interpretation
CKD is a major global health issue, with rising prevalence and increasing importance as a cause of death and as a risk factor for cardiovascular death. A better understating of aetiology, appropriate screening, and implementation programmes are needed to translate advances in CKD treatment into improved patient outcomes.
Funding
Gates Foundation, Wellcome, US National Kidney Foundation, and US National Institute of Diabetes and Digestive and Kidney Diseases.