Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016

Abstract

The last quarter century witnessed significant population growth, aging, and major changes in epidemiologic trends, which may have shaped the state of chronic kidney disease (CKD) epidemiology. Here, we used the Global Burden of Disease study data and methodologies to describe the change in burden of CKD from 1990 to 2016 involving incidence, prevalence, death, and disability-adjusted-life-years (DALYs). Globally, the incidence of CKD increased by 89% to 21,328,972 (uncertainty interval 19,100,079- 23,599,380), prevalence increased by 87% to 275,929,799 (uncertainty interval 252,442,316-300,414,224), death due to CKD increased by 98% to 1,186,561 (uncertainty interval 1,150,743-1,236,564), and DALYs increased by 62% to 35,032,384 (uncertainty interval 32,622,073-37,954,350). Measures of burden varied substantially by level of development and geography. Decomposition analyses showed that the increase in CKD DALYs was driven by population growth and aging. Globally and in most Global Burden of Disease study regions, age-standardized DALY rates decreased, except in High-income North America, Central Latin America, Oceania, Southern Sub-Saharan Africa, and Central Asia, where the increased burden of CKD due to diabetes and to a lesser extent CKD due to hypertension and other causes outpaced burden expected by demographic expansion. More of the CKD burden (63%) was in low and lower-middle-income countries. There was an inverse relationship between age-standardized CKD DALY rate and health care access and quality of care. Frontier analyses showed significant opportunities for improvement at all levels of the development spectrum. Thus, the global toll of CKD is significant, rising, and unevenly distributed; it is primarily driven by demographic expansion and in some regions a significant tide of diabetes. Opportunities exist to reduce CKD burden at all levels of development.

Sex Differences in the Progression of CKD Among Older Patients: Pooled Analysis of 4 Cohort Studies

“…Data were obtained from patients with clinical features consistent with the epidemiologic pattern of the present CKD population worldwide, namely advanced age and high prevalence of diabetes and cardiovascular disease. 32 Results of the present study agree with a very recent report from the CRIC Investigators demonstrating lower risk for ESKD in women that is similar to what is estimated in our study. 10 The results in the CRIC Study were obtained in a low-risk cohort of patients with CKD, as evidenced by the incidence rate of ESKD (3.1/100 personyears in women and 3.8/100 person-years in men) much lower than that observed in our patients (7.2 and 8.5/100 person-years in women and men, respectively), likely related to a higher eGFR, lower proteinuria, and lower BP in the CRIC cohort.…”

The topological key lncRNA H2k2 from the ceRNA network promotes mesangial cell proliferation in diabetic nephropathyviathe miR‐449a/b/Trim11/Mek signaling pathway

“…It is the leading cause of end-stage renal disease. The chronic kidney disease mortality rate was reported to have increased by 26.8% primarily because of DN (69.1%) (1). The pathogenesis of DN is closely related to a variety of factors, including the presence of glomerular mesangial lesions, the proliferation of mesangial cells (MCs), and the accumulation of extracellular matrix (ECM) (2).…”

Urinary Exosomal MicroRNA Signatures in Nephrotic, Biopsy-Proven Diabetic Nephropathy

“…Diabetic kidney disease (DKD) has emerged as a leading cause of chronic kidney disease (CKD) worldwide. It occurs in approximately 30% and 40% of patients with type 1 and 2 diabetes mellitus, respectively [1][2][3], and is more common in low-and lower-middle-income countries [4]. The clinical diagnosis of DKD is based on the measurement of the estimated glomerular filtration rate (eGFR) and the albuminuria/proteinuria, along with clinical observations, including diabetes duration and the presence of diabetic retinopathy [5,6].…”