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Kidney Int. 2018 Sep;94(3):567-581. doi: 10.1016/j.kint.2018.04.011. Epub 2018 Aug 3.

Analysis of the Global Burden of Disease study highlights the global, regional, and national trendsĀ of chronic kidney disease epidemiology from 1990 to 2016.

Author information

1
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA.
2
Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
3
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA.
4
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
5
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
6
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Nephrology Section, Medicine Service, VA St. Louis Health Care System, St. Louis, Missouri, USA.
7
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, Missouri, USA.
8
Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA; Nephrology Section, Medicine Service, VA St. Louis Health Care System, St. Louis, Missouri, USA; Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, USA. Electronic address: zalaly@gmail.com.

Abstract

The last quarter century witnessed significant population growth, aging, and major changes in epidemiologic trends, which may have shaped the state of chronic kidney disease (CKD) epidemiology. Here, we used the Global Burden of Disease study data and methodologies to describe the change in burden of CKD from 1990 to 2016 involving incidence, prevalence, death, and disability-adjusted-life-years (DALYs). Globally, the incidence of CKD increased by 89% to 21,328,972 (uncertainty interval 19,100,079- 23,599,380), prevalence increased by 87% to 275,929,799 (uncertainty interval 252,442,316-300,414,224), death due to CKD increased by 98% to 1,186,561 (uncertainty interval 1,150,743-1,236,564), and DALYs increased by 62% to 35,032,384 (uncertainty interval 32,622,073-37,954,350). Measures of burden varied substantially by level of development and geography. Decomposition analyses showed that the increase in CKD DALYs was driven by population growth and aging. Globally and in most Global Burden of Disease study regions, age-standardized DALY rates decreased, except in High-income North America, Central Latin America, Oceania, Southern Sub-Saharan Africa, and Central Asia, where the increased burden of CKD due to diabetes and to a lesser extent CKD due to hypertension and other causes outpaced burden expected by demographic expansion. More of the CKD burden (63%) was in low and lower-middle-income countries. There was an inverse relationship between age-standardized CKD DALY rate and health care access and quality of care. Frontier analyses showed significant opportunities for improvement at all levels of the development spectrum. Thus, the global toll of CKD is significant, rising, and unevenly distributed; it is primarily driven by demographic expansion and in some regions a significant tide of diabetes. Opportunities exist to reduce CKD burden at all levels of development.

KEYWORDS:

CKD burden; DALYs; age; chronic kidney disease; death; diabetes; epidemiology; global health; glomerulonephritis; hypertension; incidence; population; prevalence

PMID:
30078514
DOI:
10.1016/j.kint.2018.04.011
[Indexed for MEDLINE]
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