A1 Refereed original research article in a scientific journal
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
Authors: GBD 2023 Chronic Kidney Disease Collaborators
Publisher: Elsevier BV
Publication year: 2025
Journal: Lancet
Volume: 406
Issue: 10518
First page : 2461
Last page: 2482
ISSN: 0140-6736
eISSN: 1474-547X
DOI: https://doi.org/10.1016/S0140-6736(25)01853-7
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Partially Open Access publication channel
Web address : https://doi.org/10.1016/s0140-6736(25)01853-7
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/505547979
BackgroundChronic 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.MethodsThis 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.FindingsGlobally, 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.
InterpretationCKD 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.
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Funding information in the publication:
This study is funded by the Gates Foundation. The CKD Prognosis Consortium (CKD-PC) Data Coordinating Center is funded in part by a programme grant from the US National Kidney Foundation and the US National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100446). JSL is personally funded by a Wellcome Trust Early Career Award (301005/Z/23/Z)
