Global, Regional, and National Burden of CKD in Adults: Updated Systematic Analyses of the Global Burden of Disease Study

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Background: Chronic kidney disease (CKD) ranks among leading causes of mortality and morbidity. We present updated CKD estimates from the most recent Global Burden of Disease 2023 study to inform policy for CKD identification and treatment. Methods: We focus on adults age >20 years over 1990-2023. Data sources used were published literature, vital registration systems, renal registries, and household surveys. Estimates of CKD burden, including deaths, incidence, prevalence, and disability-adjusted life-years (DALYs), were produced. Comparative risk assessments estimated proportion of cardiovascular deaths attributable to impaired kidney function and estimate the risk factors for CKD. Results: Globally, 788 million (95% uncertainty interval 743–843) people were estimated to have CKD, up from 378 million (354–407) in 1990. Global age-standardised prevalence of CKD was 14.2% (13.4–15.2), a relative rise of 3.5% (2.7–4.1) from 1990. The region with 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). CKD was the 9th leading cause of death globally, accounting for 1.48 million (1.30–1.65) deaths, and CKD was the 12th leading cause of DALYs with age-standardised DALY rate of 769.2 per 100,000 (691.8–857.4)(see Figure). Impaired kidney function as a risk factor accounted for 11.5% (8.4–14.6) of cardiovascular deaths. Elevated plasma glucose, body-mass index, and systolic blood pressure were the leading risk factors for CKD associated DALYs. Conclusion: The prevalence of CKD continues to rise. CKD increases its importance as a cause of death (now ranking 9th for deaths and 12th for DALYs globally) and as a risk factor for cardiovascular death, increasing the urgency for translating advances in CKD treatment into improved prevention and treatment. Funding: NIDDK Support, Private Foundation SupportRank of CKD amongst leading causes of death, DALYs and as risk factor for cardiovascular death

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