Lu Yawen, Wang Lei, Ma Jianfeng, Hu Yang, Zheng Rumeng, Liu Liping, Lin Kaili, Zhang Kun, Wang Yongfeng, Li Sheng, Li Hengping
The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China.
Yanan University Affiliated Hospital, Yanan, Shanxi, China.
Front Nephrol. 2025 Aug 18;5:1630867. doi: 10.3389/fneph.2025.1630867. eCollection 2025.
Chronic kidney disease (CKD) is a progressive condition affecting over 10% of the global population, with high sodium intake identified as a critical modifiable risk factor. This study investigated the global burden of CKD due to excessive sodium intake in 204 countries and territories from 1990 to 2021 and made the first future projections to 2040, addressing gaps in longitudinal analysis of sodium-related CKD trends and demographic differences.
Data from the Global Burden of Disease (GBD) 2021 database were analyzed to quantify CKD-related deaths and disability-adjusted life years (DALYs) linked to high sodium intake. Age-standardized mortality rates (ASMR) and DALY rates (ASDR), alongside the sociodemographic index (SDI), were used to assess regional and demographic variations. Statistical analyses in R included joinpoint regression to identify temporal inflection points and age-period-cohort (APC) modeling to disentangle age, period, and birth cohort effects. Future projections show that from 2021 to 2040, the global ASMR trend is stabilizing and ASDR is on the rise. Moreover, male ASMR and ASDR have been consistently higher than female ASMR. This gender difference is expected to continue for a long time, with men continuing to bear a greater burden of chronic kidney disease than women.
Between 1990 and 2021, global CKD deaths attributed to high sodium intake surged 1.68-fold (26,072 to 69,954), while DALYs increased by 135% (741,197 to 1,705,325). ASMR and ASDR rose markedly in high-income regions (20.73% and 6.77%, respectively), with Latin America and the Caribbean reporting the highest burdens (ASMR: 1.49/100,000; ASDR: 33.21/100,000). Men exhibited consistently higher burdens than women, peaking in the 65-79 age group. Low SDI regions showed declining trends, contrasting with widening inequalities in medium SDI areas.
The global CKD burden attributable to high sodium intake has escalated dramatically over three decades, driven by aging populations, dietary shifts, and regional disparities. Urgent, targeted interventions-such as sodium reduction policies, gender-specific health strategies, and enhanced healthcare access-are critical to curbing this trend, particularly in high-risk demographics and high-income regions.
慢性肾脏病（CKD）是一种渐进性疾病，影响着全球超过10%的人口，高钠摄入被确定为一个关键的可改变风险因素。本研究调查了1990年至2021年期间204个国家和地区因钠摄入过量导致的慢性肾脏病的全球负担，并首次对2040年进行了未来预测，填补了钠相关慢性肾脏病趋势纵向分析和人口差异方面的空白。
分析全球疾病负担（GBD）2021数据库中的数据，以量化与高钠摄入相关的慢性肾脏病死亡人数和伤残调整生命年（DALYs）。使用年龄标准化死亡率（ASMR）和DALY率（ASDR）以及社会人口指数（SDI）来评估区域和人口差异。R语言中的统计分析包括用于识别时间拐点的连接点回归和用于分解年龄、时期和出生队列效应的年龄-时期-队列（APC）模型。未来预测显示，从2021年到2040年，全球ASMR趋势趋于稳定，ASDR呈上升趋势。此外，男性的ASMR和ASDR一直高于女性的ASMR。这种性别差异预计将持续很长时间，男性将继续比女性承担更大的慢性肾脏病负担。
1990年至2021年期间，全球因高钠摄入导致的慢性肾脏病死亡人数激增1.68倍（从26,072人增至69,954人），而DALYs增加了135%（从741,197增至1,705,325）。高收入地区的ASMR和ASDR显著上升（分别为20.73%和6.77%），拉丁美洲和加勒比地区的负担最重（ASMR：1.49/10万；ASDR：33.21/10万）。男性的负担一直高于女性，在65-79岁年龄组达到峰值。低SDI地区呈下降趋势，而中等SDI地区的不平等现象在加剧。
由于人口老龄化、饮食结构变化和区域差异，全球因高钠摄入导致的慢性肾脏病负担在三十年内急剧上升。紧急、有针对性的干预措施，如减钠政策、针对性别的健康策略以及改善医疗服务可及性，对于遏制这一趋势至关重要，特别是在高风险人群和高收入地区。
