A new study has revealed chronic kidney disease (CKD) as a potent and often overlooked driver of heart disease.
The research, published on Friday in The Lancet, attributes the sharp rise in CKD largely to the growing prevalence of other chronic conditions, including diabetes, high blood pressure, and obesity.
The analysis, which drew data from the Global Burden of Disease 2023 study, tracked CKD trends among adults across 204 countries and territories from 1990 to 2023.
The findings paint a concerning picture: in 2023, CKD was the ninth-leading cause of death globally, claiming nearly 1.5 million lives, and the 12th-leading cause of disability.
The study estimates that approximately 788 million adults aged 20 and older — roughly 14% of the global adult population — were living with CKD in 2023.
This marks a significant increase from just over 12% in 1990. Unlike many other major causes of death, the global mortality rate from CKD has also risen, from 24.9 to 26.5 deaths per 100,000 people over the same period.
Researchers identify the aging global population and the escalating epidemics of diabetes, high blood pressure, and obesity as the primary drivers of this trend, though increased awareness and diagnosis may also contribute to the higher numbers.
The burden of CKD is widespread. China and India, with their vast populations, have the highest number of affected adults at 152 million and 138 million, respectively.
However, the disease is pervasive, with the United States, Indonesia, Japan, Brazil, Russia, Mexico, Nigeria, Pakistan, Bangladesh, Iran, the Philippines, Vietnam, Thailand, and Turkey each reporting more than 10 million adults living with CKD.
The study establishes CKD as a major contributor to cardiovascular disease. In 2023, impaired kidney function was responsible for nearly 12% of all global deaths from heart disease — a greater share than the risk attributed to diabetes or obesity.
The research identified 14 key risk factors for CKD, with diabetes, high blood pressure, obesity, and poor diet (characterized by low fruit and vegetable intake and high salt consumption) having the most significant health impacts.
Theo Vos, the study’s senior author, highlighted the disparity between CKD’s growing impact and the limited policy attention it receives.
“Chronic kidney disease is both a major risk factor for other leading causes of health loss and a significant disease burden in its own right,” he said.
“Yet, it continues to receive far less policy attention than other non-communicable diseases, even as its impact grows fastest in regions already facing the greatest health inequities.”
The highest rates of CKD are concentrated in North Africa, the Middle East, South Asia, sub-Saharan Africa, and Latin America. A key finding offers a glimmer of hope: most people with CKD in 2023 were in the early stages of the disease.
This underscores the critical need for enhanced screening, accessible treatments, and strategies to control blood sugar and blood pressure.
With access to life-saving dialysis and kidney transplants remaining limited and uneven globally, the study concludes that a greater focus must be placed on preventing disease progression, improving access to diagnosis and care, and addressing its key risk factors to curb the escalating global burden of chronic kidney disease.
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