What is the global burden of chronic kidney disease (CKD), and why is it important?

Measuring global, regional, and national burden

The burden of disease is the measure of the human and economic costs resulting from a given adverse health condition or group of conditions within a population. In response to one of the United Nations Sustainable Development Goals to reduce premature death from non-communicable diseases by one third come 2030, scientists from around the world collaborated to analyze the global, regional, and national burdens of CKD and suggest remedial actions.

Called the  Global Burden of Diseases, Injuries, and Risk Factors Study 2017, the scientists’ research explored the changes in CKD burden in 195 countries from 1990 to 2017, along with the burdens of cardiovascular disease (CVD) and gout from impaired kidney function.* Their findings were cause for dismay. 

Analysis and results

Between 1990 and 2017, the number of people with CKD increased by 29.3% worldwide, while CKD as a cause of death rose by 41.5%.

As of 2017:

• An alarming 9.1% of the global population had CKD.
• CKD ranked as the 12th leading cause of death globally, up from 17th in 1990.
• There were 697.5 million cases of CKD globally, which was more than those with diabetes, chronic obstructive pulmonary disease (COPD), asthma, osteoarthritis, or depressive disorders.
• More than 2.5 million people received renal replacement therapy—projected to double to 5.4 million by 2030.
• While availability of renal replacement therapy (RRT) increased from 1990 to 2017, access is still limited in many regions, resulting in about 2.3 to 7.1 million premature deaths in adults.
• CKD directly resulted in 1.2 million deaths, which is expected to rise to between 2.2 million and 4 million by 2040.
• An additional 1.4 million deaths from cardiovascular disease were attributable to impaired kidney function.
• CKD and its effect on cardiovascular disease resulted in a combined 2.6 million deaths globally—more than tuberculosis or HIV—and nearly equal to the number of deaths from road injuries.

CKD’s rise in mortality rank between 1990 and 2017 is largely due to global aging and the increasing burden of CKD risk factors (diabetes, hypertension, and obesity, for example), particularly in poorer countries. In contrast, many higher-profile chronic diseases, such as COPD, cardiovascular disease, and cancer, have seen significant declines during the same time period.

Call to action 

According to the authors, in order to achieve better outcomes and reduce the burden of CKD, a comprehensive action plan should include:

• raising awareness of CKD among healthcare personnel, healthcare authorities, and the general public;
• management of risk factors at the primary care level;
• preventive treatments and early detection programs among high-risk populations;
• more effective treatment during the early stages of the disease; and
• establishment of more facilities for treating patients with CKD.

*GBD Chronic Kidney Disease Collaboration. (2020, Feb. 13). “Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017.” The Lancet.