TY - JOUR
T1 - Global, regional, and national burden of chronic kidney disease, 1990–2017
T2 - a systematic analysis for the Global Burden of Disease Study 2017
AU - GBD Chronic Kidney Disease Collaboration
AU - Bikbov, Boris
AU - Purcell, Caroline A.
AU - Levey, Andrew S.
AU - Smith, Mari
AU - Abdoli, Amir
AU - Abebe, Molla
AU - Adebayo, Oladimeji M.
AU - Afarideh, Mohsen
AU - Agarwal, Sanjay Kumar
AU - Agudelo-Botero, Marcela
AU - Ahmadian, Elham
AU - Al-Aly, Ziyad
AU - Alipour, Vahid
AU - Almasi-Hashiani, Amir
AU - Al-Raddadi, Rajaa M.
AU - Alvis-Guzman, Nelson
AU - Amini, Saeed
AU - Andrei, Tudorel
AU - Andrei, Catalina Liliana
AU - Andualem, Zewudu
AU - Anjomshoa, Mina
AU - Arabloo, Jalal
AU - Ashagre, Alebachew Fasil
AU - Asmelash, Daniel
AU - Ataro, Zerihun
AU - Atout, Maha Moh d.Wahbi
AU - Ayanore, Martin Amogre
AU - Badawi, Alaa
AU - Bakhtiari, Ahad
AU - Ballew, Shoshana H.
AU - Balouchi, Abbas
AU - Banach, Maciej
AU - Barquera, Simon
AU - Basu, Sanjay
AU - Bayih, Mulat Tirfie
AU - Bedi, Neeraj
AU - Bello, Aminu K.
AU - Bensenor, Isabela M.
AU - Bijani, Ali
AU - Boloor, Archith
AU - Borzì, Antonio M.
AU - Cámera, Luis Alberto
AU - Carrero, Juan J.
AU - Carvalho, Félix
AU - Castro, Franz
AU - Catalá-López, Ferrán
AU - Chang, Alex R.
AU - Chin, Ken Lee
AU - Chung, Sheng Chia
AU - Fernandes, João C.
N1 - Funding Information:
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) was supported by The Bill & Melinda Gates Foundation . BB has received funding from the European Union's Horizon 2020 research and innovation programme under a Marie Sklodowska-Curie grant (agreement no 703226). AlBa acknowledges support by the Public Health Agency of Canada. JJC acknowledges support from the Swedish Research Council (grant 2019-01059). FéCa and EF acknowledge support from UID/MULTI/04378/2019 and UID/QUI/50006/2019 with FCT/MCTES support through Portuguese national funds. ARC was supported by The National Institute of Diabetes and Digestive and Kidney Diseases (grants R01DK100446 and K23DK106515). JCF acknowledges support by Portuguese national funds from FCT (Fundação para a Ciência e a Tecnologia) through project UID/Multi/50016/2019. MF acknowledges support from European Union (FEDER funds through COMPETE POCI-01-0145-FEDER-029248) and Portuguese national funds (FCT) through project PTDC/NAN-MAT/29248/2017. SMSI acknowledges support from the National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. IMV acknowledges support from the Sistema Nacional de Investigacion Panama. JBN acknowledges support from the Fogarty International Center of the National Institutes of Health (award no R25TW011217 and 1D43TW010937-01A1). CN acknowledges support from a European Society for the Study of Diabetes/Lilly Young Investigator Research Award. AO acknowledges support from PI16/02057, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018, KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009 FEDER funds, Fundacion Renal Iñigo Álvarez de Toledo, and Comunidad de Madrid CIFRA2 B2017/BMD-3686. AES acknowledges support from the South African National Research Foundation (SARChI GUN 86895) and South African Medical Research Council. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of associated institutes. We thank Kerstin Mierke for editorial assistance preparing the report.
Funding Information:
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) was supported by The Bill & Melinda Gates Foundation. BB has received funding from the European Union's Horizon 2020 research and innovation programme under a Marie Sklodowska-Curie grant (agreement no 703226). AlBa acknowledges support by the Public Health Agency of Canada. JJC acknowledges support from the Swedish Research Council (grant 2019-01059). F?Ca and EF acknowledge support from UID/MULTI/04378/2019 and UID/QUI/50006/2019 with FCT/MCTES support through Portuguese national funds. ARC was supported by The National Institute of Diabetes and Digestive and Kidney Diseases (grants R01DK100446 and K23DK106515). JCF acknowledges support by Portuguese national funds from FCT (Funda??o para a Ci?ncia e a Tecnologia) through project UID/Multi/50016/2019. MF acknowledges support from European Union (FEDER funds through COMPETE POCI-01-0145-FEDER-029248) and Portuguese national funds (FCT) through project PTDC/NAN-MAT/29248/2017. SMSI acknowledges support from the National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. IMV acknowledges support from the Sistema Nacional de Investigacion Panama. JBN acknowledges support from the Fogarty International Center of the National Institutes of Health (award no R25TW011217 and 1D43TW010937-01A1). CN acknowledges support from a European Society for the Study of Diabetes/Lilly Young Investigator Research Award. AO acknowledges support from PI16/02057, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018, KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009 FEDER funds, Fundacion Renal I?igo ?lvarez de Toledo, and Comunidad de Madrid CIFRA2 B2017/BMD-3686. AES acknowledges support from the South African National Research Foundation (SARChI GUN 86895) and South African Medical Research Council. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of associated institutes. We thank Kerstin Mierke for editorial assistance preparing the report. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
Publisher Copyright:
© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access Article under the CC BY 4.0 license.
PY - 2020/2/29
Y1 - 2020/2/29
N2 - Background: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings: Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Funding: Bill & Melinda Gates Foundation.
AB - Background: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings: Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Funding: Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85079872533&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(20)30045-3
DO - 10.1016/S0140-6736(20)30045-3
M3 - Article
C2 - 32061315
AN - SCOPUS:85079872533
SN - 0140-6736
VL - 395
SP - 709
EP - 733
JO - Lancet
JF - Lancet
IS - 10225
ER -