Li Min-Jia, Liu Hong-Yong, Zhang Yun-Qiang, Li Sheng-Rong, Zhang Jian-Hong, Li Rong
Department of Nephrology, The Third Affiliated Hospital of Sun Yat-Sen University, Yuedong Hospital, Meizhou, Guangdong, China.
Front Endocrinol (Lausanne). 2025 Jul 3;16:1563246. doi: 10.3389/fendo.2025.1563246. eCollection 2025.
Chronic kidney disease is a global health challenge, especially in resource-limited regions. Understanding its burden and key risk factors is crucial for effective interventions.
Data from the Global Burden of Disease Study (1990-2021) covering 204 countries were analyzed to assess trends in prevalence, mortality, and disability-adjusted life years for chronic kidney disease, alongside geographic, age, sex, and risk factor patterns.
In 2021, an estimated 674 million individuals were affected globally. Although the global age-standardized prevalence rate declined slightly by 0.8% since 1990, substantial disparities persisted. High-income North America's prevalence remained stable yet showed high mortality (20.6 per 100,000) and increased DALYs (508.8 per 100,000). In contrast, East Asia's prevalence fell by 11.7%, accompanied by notable reductions in mortality (11.1 per 100,000) and DALYs (322.4 per 100,000). Regions with low socio-demographic indices, including parts of sub-Saharan Africa and South Asia, bore the greatest burdens, with persistently high prevalence (exceeding 9000 per 100,000) and rising DALYs. Some countries, such as Guatemala, experienced rapid prevalence increases, while others, like Italy, achieved substantial reductions. Similarly, mortality trends varied: Ukraine saw steep increases, while Poland showed marked improvements. DALY burdens also diverged, with El Salvador experiencing large increases, and Kuwait recording significant declines. Prevalence peaked at ages 65-69 in males and 70-74 in females, with female rates surpassing male rates from the early thirties onward. High fasting plasma glucose contributed 36% of DALYs globally, heavily affecting the Caribbean and high-income North America. High systolic blood pressure and high body mass index were particularly influential in Central Europe and high-income North America, respectively. Low fruit intake strongly affected the Middle East and East Asia.
These findings underscore persistent global inequalities in CKD outcomes, necessitating region-specific strategies and strengthened healthcare capacity to mitigate the burden.
慢性肾脏病是一项全球性的健康挑战，在资源有限的地区尤为如此。了解其负担和关键风险因素对于有效干预至关重要。
分析了来自涵盖204个国家的全球疾病负担研究（1990 - 2021年）的数据，以评估慢性肾脏病的患病率、死亡率和伤残调整生命年的趋势，以及地理、年龄、性别和风险因素模式。
2021年，全球估计有6.74亿人受到影响。尽管自1990年以来全球年龄标准化患病率略有下降0.8%，但仍存在显著差异。高收入的北美洲患病率保持稳定，但死亡率较高（每10万人中有20.6人），伤残调整生命年增加（每10万人中有508.8人）。相比之下，东亚的患病率下降了11.7%，同时死亡率（每10万人中有11.1人）和伤残调整生命年（每10万人中有322.4人）显著降低。社会人口指数较低的地区，包括撒哈拉以南非洲和南亚的部分地区，负担最重，患病率持续居高不下（超过每10万人9000人），伤残调整生命年不断上升。一些国家，如危地马拉，患病率迅速上升，而其他国家，如意大利，则大幅下降。同样，死亡率趋势也各不相同：乌克兰急剧上升，而波兰则有显著改善。伤残调整生命年负担也存在差异，萨尔瓦多大幅增加，而科威特则显著下降。患病率在男性65 - 69岁、女性70 - 74岁时达到峰值，从三十出头开始女性患病率超过男性。高空腹血糖占全球伤残调整生命年的36%，对加勒比地区和高收入的北美洲影响严重。高收缩压和高体重指数分别在中欧和高收入的北美洲具有特别大的影响。低水果摄入量对中东和东亚影响很大。
这些发现凸显了慢性肾脏病结局在全球范围内持续存在的不平等现象，需要制定针对特定区域的策略并加强医疗保健能力以减轻负担。
