Burden of chronic kidney disease and its attributable risk factors in 204 countries and territories, 1990–2021: Results from the Global Burden of Disease study 2021

Chronic kidney disease (CKD) remains a major contributor to global mortality and morbidity. This study reports the global, regional, and national burden of CKD and its attributable risk factors from 1990 to 2021. Data were systematically analyzed using the Global Burden of Disease 2021 study. CKD prevalence, deaths, and disability-adjusted life years (DALYs), along with their attributable risk factors, were retrieved for 204 countries and territories from 1990 to 2021. Temporal trends were assessed using the percentage change in age‑standardized rates, with stratified analyses by Global Burden of Disease super‑region, country, age, sex, and sociodemographic index quintiles. In 2021, CKD affected 673.7 million people worldwide, resulting in 1.53 million deaths and causing 44.45 million DALYs. Key findings include: first, the global age-standardized prevalence rate of CKD was 8006 per 100,000 people, a 4.5% decrease since 1990. However, the age-standardized mortality rate increased by 24.6% to 18.5 per 100,000. Second, the highest CKD prevalence was observed in Central Asia, Southeast Asia, and South Asia, while the lowest was found in Western Europe and Eastern Sub-Saharan Africa. Third, high blood glucose, hypertension, and obesity were identified as the leading contributors to CKD-related DALYs globally. The global burden of CKD continues to rise, with mortality and DALYs increasing particularly in low- and middle-income countries. Urgent public health strategies targeting high blood glucose, hypertension, and obesity are critical to reducing the rising global burden of CKD.