Chen Jing, Li Chunyang, Bu Ci Li Nong, Wang Yujiao, Qi Mei, Fu Ping, Zeng Xiaoxi
Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Chin Med J (Engl). 2024 May 28. doi: 10.1097/CM9.0000000000003143.
Spatiotemporal disparities exist in the disease burden of non-communicable diseases (NCDs) attributable to kidney dysfunction, which has been poorly assessed. The present study aimed to evaluate the spatiotemporal trends of the global burden of NCDs attributable to kidney dysfunction and to predict future trends.
Data on NCDs attributable to kidney dysfunction, quantified using deaths and disability-adjusted life-years (DALYs), were extracted from the Global Burden of Diseases Injuries, and Risk Factors (GBD) Study in 2019. Estimated annual percentage change (EAPC) of age-standardized rate (ASR) was calculated with linear regression to assess the changing trend. Pearson's correlation analysis was used to determine the association between ASR and Sociodemographic Index (SDI) for 21 GBD regions. A Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2040.
Between 1990 and 2019, the absolute number of deaths and DALYs from NCDs attributable to kidney dysfunction increased globally. The death cases increased from 1,571,720 (95% uncertainty interval [UI]: 1,344,420-1,805,598) in 1990 to 3,161,552 (95% UI: 2,723,363-3,623,814) in 2019 for both sexes combined. Both the ASR of death and DALYs increased in Andean Latin America, the Caribbean, Central Latin America, Southeast Asia, Oceania, and Southern Sub-Saharan Africa. In contrast, the age-standardized metrics decreased in the high-income Asia Pacific region. The relationship between SDI and ASR of death and DALYs was negatively correlated. The BAPC model indicated that there would be approximately 5,806,780 death cases and 119,013,659 DALY cases in 2040 that could be attributed to kidney dysfunction. Age-standardized death of cardiovascular diseases (CVDs) and CKD attributable to kidney dysfunction were predicted to decrease and increase from 2020 to 2040, respectively.
NCDs attributable to kidney dysfunction remain a major public health concern worldwide. Efforts are required to attenuate the death and disability burden, particularly in low and low-to-middle SDI regions.
归因于肾功能障碍的非传染性疾病（NCDs）的疾病负担存在时空差异，对此评估不足。本研究旨在评估归因于肾功能障碍的全球非传染性疾病负担的时空趋势，并预测未来趋势。
从《2019年全球疾病、伤害及风险因素负担研究》（Global Burden of Diseases Injuries, and Risk Factors, GBD）中提取了归因于肾功能障碍的非传染性疾病数据，使用死亡人数和伤残调整生命年（DALYs）进行量化。通过线性回归计算年龄标准化率（ASR）的估计年度百分比变化（EAPC），以评估变化趋势。采用Pearson相关分析确定21个GBD区域的ASR与社会人口学指数（SDI）之间的关联。使用贝叶斯年龄-时期-队列（BAPC）模型预测至2040年的未来趋势。
1990年至2019年期间，全球归因于肾功能障碍的非传染性疾病的死亡人数和DALYs绝对值有所增加。1990年，合并两性的死亡病例为1,571,720例（95%不确定区间[UI]：1,344,420 - 1,805,598），到2019年增至3,161,552例（95% UI：2,723,363 - 3,623,814）。安第斯拉丁美洲、加勒比地区、中拉丁美洲、东南亚、大洋洲和撒哈拉以南非洲南部的死亡ASR和DALYs均有所增加。相比之下，高收入亚太地区的年龄标准化指标有所下降。SDI与死亡ASR和DALYs之间呈负相关。BAPC模型表明，到2040年，约有5,806,780例死亡病例和119,013,659例DALY病例可归因于肾功能障碍。预计2020年至2040年期间，归因于肾功能障碍的心血管疾病（CVDs）和慢性肾脏病（CKD）的年龄标准化死亡率将分别下降和上升。
归因于肾功能障碍的非传染性疾病仍然是全球主要的公共卫生问题。需要做出努力以减轻死亡和残疾负担，特别是在低SDI和低至中等SDI地区。
