Abstract
Background
Chronic kidney disease (CKD) is a global public health concern, but its disease burden and risk-attributable burden in CKD has been poorly studied in low - and middle-income countries (LMICs). This study aimed to estimate CKD burden and risk-attributable burden in LMICs from 1990 to 2019.
Methods
Data were collected from the Global Burden of Disease (GBD) Study 2019, which measure CKD burden using the years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs) and estimate risk-attributable burden using population-attributable faction (PAF) from 1990 to 2019. The 95% uncertainty intervals (UIs) were calculated and reported for YLDs, YLLs and DALYs.
Results
In 2019, the age-standardized YLL rate is much higher than the YLD rate in various income regions. LICs had the highest age-standardized DALY rate at 692.25 per 100,000 people (95%UI: 605.14 to 785.67), followed by Lower MICs. From 1990 to 2019, the age-standardized DALY rate showed a 13.70% reduction in LICs, 2.25% reduction Upper MICs but 3.72% rising in Lower MICs. Age-standardized YLD rate was higher in females than in males, whereas age-standardized rates of YLL and DALY of CKD were all higher in males than in females in globally and various income regions. Additionally, there were upward trends in the CKD-related age-specific YLD, YLL and DALY rates in various income regions. In 2019, kidney dysfunction, high systolic blood pressure, high fasting plasma glucose, and high body-mass index remained the major causes attributable age-standardized CKD DALYs. From 1990 to 2019, there were upward trends in the PAF contributions of high fasting plasma glucose, high systolic blood pressure, and high body-mass index. The greatest increase in the PAF was high body-mass index, especially in Lower MICs.
Conclusions
CKD burden remains high in various income regions, especially in MICs and Lower MICs. More effective and targeted preventive policies and interventions aimed at mitigating preventable CKD burden and addressing risk factors are urgently needed, particularly in geographies with high or increasing burden.
The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study
