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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 Publisher Pubmed



Mark PB ; Stafford LK ; Grams ME ; Aalruz H ; Abd Elhafeez S ; Abdelgalil AA ; Abdulkader RS ; Abeywickrama HM ; Abiodun OO ; Abramov D ; Abrar MM ; Abreu LG ; Abubakar B ; Aburuz S Show All Authors
Authors
  1. Mark PB
  2. Stafford LK
  3. Grams ME
  4. Aalruz H
  5. Abd Elhafeez S
  6. Abdelgalil AA
  7. Abdulkader RS
  8. Abeywickrama HM
  9. Abiodun OO
  10. Abramov D
  11. Abrar MM
  12. Abreu LG
  13. Abubakar B
  14. Aburuz S
  15. Addo IY
  16. Adegboye OA
  17. Adegoke NA
  18. Adeyeoluwa TE
  19. Adnani QES
  20. Ahinkorah BO
  21. Ahmad S
  22. Ahmad K
  23. Ahmadi A
  24. Ahmadzade AM
  25. Ahmed A
  26. Ahmed AM
  27. Ahmed N
  28. Ahmed S
  29. Ahmed SA
  30. Ajami M
  31. Akbari M
  32. Akeju O
  33. Akkaif MA
  34. Al Awaidy S
  35. Al Hamad H
  36. Al Hasan SM
  37. Al Thaher Y
  38. Alaly Z
  39. Alashwal FY
  40. Albashtawy M
  41. Aleidi SM
  42. Alfalki AM
  43. Alhalaiqa FN
  44. Alhasan KA
  45. Ali EA
  46. Ali R
  47. Ali SS
  48. Ali SY
  49. Aljabi SW
  50. Allouh MZ
  51. Almagharbeh WT
  52. Almidani O
  53. Alnawafleh KA
  54. Alshahrani NZ
  55. Altaf A
  56. Alvisguzman N
  57. Alworafi YM
  58. Alzoubi KH
  59. Alzubairi AS
  60. Aman Mohammadi M
  61. Amu H
  62. Anagnostakis F
  63. Anil A
  64. Anyasodor AE
  65. Apostol GLC
  66. Appati W
  67. Araromi SO
  68. Aravkin AY
  69. Arnlov J
  70. Arockiaraj J
  71. Asiamahasare BKY
  72. Asri Y
  73. Assaye AM
  74. Atout MMW
  75. Aurangzeb K
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Source: The Lancet Published:2025


Abstract

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. © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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