Qin Kaili, Qing Jianbo, Wang Qian, Li Yafeng
The Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, China.
The Third Clinical Medical College, Zhejiang University School of Medicine, Hangzhou, 310000, China.
BMC Public Health. 2024 Dec 18;24(1):3519. doi: 10.1186/s12889-024-21065-9.
Chronic kidney disease (CKD) presents a growing global health challenge, with significant variability in disease burden across different regions and countries. This study aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for CKD from 1990 to 2019, utilizing data from the Global Burden of Disease Study.
We conducted an in-depth study on the global and age-standardized incidence, prevalence, mortality, and DALYs of CKD, and assessed trends over a 30-year period. Additionally, we explored the associations between healthcare access and quality (HAQ), the Socio-Demographic Index (SDI), and CKD. Furthermore, we conducted a detailed analysis of six risk factors closely related to CKD, and based on these findings, provided strong evidence for enhancing the management of CKD.
In 2019, there were 18,986,903 cases of CKD, with an average annual percent change (AAPC) of 1.82 (95% CI = 1.8 to 1.82) in incidence since 1990. The age-standardized incidence rate increased from 192.45 per 100,000 in 1990 to 233.65 per 100,000 in 2019. Prevalence also rose, with a total of 69,729,430 cases in 2019 and an AAPC of 1.19 (95% CI = 1.19 to 1.2). Mortality and DALYs have increased correspondingly, with the mortality rate reaching 18.29 per 100,000 and total DALYs at 41,538,592 in 2019. The analysis showed that higher HAQ levels are associated with better outcomes in terms of lower mortality and DALY rates, whereas lower HAQ levels correlate with poorer outcomes. In addition, high fasting plasma glucose and high systolic blood pressure are the main contributors to CKD-related deaths, with their population attributable fraction (PAF) significantly decreasing as the SDI decreases.
The burden of CKD has significantly increased over the past three decades, influenced by demographic changes and variations in healthcare quality and access. Effective public health strategies and improvements in healthcare delivery are needed to address the disparities in CKD outcomes globally.
慢性肾脏病（CKD）是一项日益严峻的全球健康挑战，不同地区和国家的疾病负担存在显著差异。本研究旨在利用全球疾病负担研究的数据，分析1990年至2019年CKD的发病率、患病率、死亡率和伤残调整生命年（DALYs）的变化趋势。
我们对CKD的全球及年龄标准化发病率、患病率、死亡率和DALYs进行了深入研究，并评估了30年间的变化趋势。此外，我们还探讨了医疗服务可及性与质量（HAQ）、社会人口指数（SDI）与CKD之间的关联。此外，我们对与CKD密切相关的六个风险因素进行了详细分析，并基于这些发现，为加强CKD管理提供了有力证据。
2019年，CKD病例达18,986,903例，自1990年以来发病率的年均变化百分比（AAPC）为1.82（95%CI = 1.8至1.82）。年龄标准化发病率从1990年的每10万人192.45例增至2019年的每10万人233.65例。患病率也有所上升，2019年共有69,729,430例，AAPC为1.19（95%CI = 1.19至1.2）。死亡率和DALYs相应增加，2019年死亡率达每10万人18.29例，总DALYs为41,538,592例。分析表明，较高的HAQ水平与较低的死亡率和DALY率相关的较好结局相关，而较低的HAQ水平与较差的结局相关。此外，空腹血糖升高和收缩压升高是CKD相关死亡的主要原因，其人群归因分数（PAF）随着SDI的降低而显著下降。
在过去三十年中，受人口结构变化以及医疗质量和可及性差异的影响，CKD的负担显著增加。需要有效的公共卫生策略和改善医疗服务提供，以解决全球CKD结局的差异问题。
