Global, Regional, and National Burden of CKD in Children and Adolescents from 1990 to 2019

Wen-Man Zhao; Xun-Liang Li; Rui Shi; Yuyu Zhu; Zhi-Juan Wang; Xue-Rong Wang; Hai-Feng Pan; De-Guang Wang

doi:10.1093/ndt/gfad269

Global, Regional, and National Burden of CKD in Children and Adolescents from 1990 to 2019

Nephrol Dial Transplant. 2023 Dec 21:gfad269. doi: 10.1093/ndt/gfad269. Online ahead of print.

Authors

Wen-Man Zhao^{1

2}, Xun-Liang Li^{1

2}, Rui Shi^{1

2}, Yuyu Zhu^{1

2}, Zhi-Juan Wang^{1

2}, Xue-Rong Wang^{1

2}, Hai-Feng Pan^{3

4}, De-Guang Wang^{1

2}

Affiliations

¹ Department of Nephrology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
² Institute of Kidney Disease, Inflammation & Immunity-mediated Diseases, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
³ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
⁴ Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China.

PMID: 38130213
DOI: 10.1093/ndt/gfad269

Abstract

Background and aims: CKD is one of the most prevalent non-communicable health concerns in children and adolescents worldwide; however, data on its incidence, prevalence, disability-adjusted life years (DALYs), and trends in the population are limited. We aimed to assess the global, regional, and national trends in CKD burden in children and adolescents.

Methods: In this trend analysis based on the 2019 Global Diseases, Injuries, and Risk Factors Study, CKD incidence, prevalence, and DALYs rates per 100,000 population for children and adolescents were reported at the global, regional, and national levels, as well as the average annual percentage change (AAPC). These global trends were analyzed by age, sex, region, and socio-demographic index (SDI).

Results: Globally, the overall incidence of CKD (all stages including KRT) in children and adolescents showed an increasing trend (AAPC 0.44 [95% CI 0.36-0.52]) between 1990 and 2019. Similarly, the overall prevalence of CKD also showed an upward trend (AAPC 0.46 [95% CI 0.42-0.51]). However, the DALYs of CKD showed a continuous decreasing trend (AAPC -1.18[-1.37- -0.99]). The population aged 15-19 years had the largest CKD incidence increase during this period. The largest increase in age-standardized incidence rate (ASIR) was in middle SDI countries (AAPC 0.56 [0.45-0.67]). The relationship between the ASIR and SDI showed an inverse U-shaped correlation while the relationship between the age-standardized DALYs rate (ASDR) and SDI showed an inverse trend with SDI. Among adolescents (15-19 years), the ASIR continued to increase for five causes of CKD, owing to type 2 diabetes mellitus and hypertension. Most of the disease burden was concentrated in countries with a lower SDI. Andean Latin America and Central Latin America showed the largest increases in CKD ASIR between 1990 and 2019.

Conclusion: The burden of CKD in children and adolescents has increased worldwide, especially in regions and countries with a lower SDI.

Keywords: CKD; GBD; adolescents; children; incidence.