BACKGROUND

Hypertension is a major risk factor for chronic kidney disease (CKD), and the global burden of CKD due to hypertension is rising with population aging. Previous GBD-related studies on CKD have limitations, and the updated global burden of disease (GBD) 2021 database can provide a more comprehensive understanding.

OBJECTIVE

This study aims to analyze the global, regional, and national burden of CKD due to hypertension from 1990 to 2021, identify risk factors, and project trends until 2036.

METHOD

Data from the GBD 2021 study for 204 countries and territories were used. Prevalence, incidence, deaths, and disability-adjusted life years (DALYs) of CKD due to hypertension were analyzed. Decomposition analysis, frontier analysis, and predictive analysis were performed. The impact of level 3 risk factors was also assessed.

RESULTS

In 2021, the global prevalence of CKD attributed to hypertension exceeded 24 million cases, with an age-standardized prevalence rate of 291.19 per 100,000. The incidence of such CKD cases surpassed 1.28 million, corresponding to an age-standardized incidence rate of 14.97 per 100,000. Mortality from CKD due to hypertension claimed over 454,000 lives, translating to an age-standardized mortality rate of 5.54 per 100,000. Additionally, the disease inflicted more than 10.85 million DALYs, which equates to an age-standardized DALYs rate of approximately 128.41 per 100,000. There were gender and age differences in the disease burden. Decomposition analysis indicated that population growth aggravated the disease burden in different aspects, and epidemiological changes and aging had varying effects. Frontier analysis revealed disparities among regions with different socio-demographic index (SDI) levels. Predictive analysis showed that from 2021 to 2036, the overall prevalence and incidence would remain stable with gender differences, and the age-standardized rates of mortality and DALYs would continue to rise. Dietary risk factors, especially low fruit intake, were the main contributors, along with low-temperature and lead exposure.

CONCLUSIONS

Despite a decline in age-standardized prevalence in some aspects, the overall disease burden of CKD due to hypertension has increased. Targeted strategies such as gender-and age-specific prevention, dietary improvements, environmental protection, and optimized medical resource allocation are essential to address this public-health challenge.