2025
Chronic kidney disease burden from 1990 to 2023 in China: national and provincial insights from the Global Burden of Diseases study 2023
Publication Information
Title: Chronic kidney disease burden from 1990 to 2023 in China: national and provincial insights from the Global Burden of Diseases study 2023
Author(s):Guanhao He, Jiangmei Liu, Yi Lin, Jinlei Qi, Jianxiong Hu, Peng Yin, Tao Liu, Ziqiang Lin, Fengrui Jing, Jinling You, Fanna Liu, Wenjun Ma, Maigeng Zhou
Journal Name, Year, Volume(Issue): Page range:The Lancet Regional Health - Western Pacific, 2025, 68: 101776
DOI:10.1016/j.lanwpc.2025.101776
Abstract:
Background: Chronic kidney disease (CKD) is known as a silent killer and poses considerable disease burden. This study aimed to assess the disease burden of CKD in China and its provinces from 1990 to 2023.
Methods: This study used data on CKD in China and its provinces from the Global Burden of Diseases Study (GBD) 2023, and analyzed the disease burden of CKD in 2023 and its change from 1990 to 2023 using indicators including prevalence, death, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs).
Findings: China had 156.15 (95% UI: 146.77-167.88) million people with CKD in 2023, resulting in 153.89 (95% UI: 128.52-182.22) thousand deaths, 3.23 (95% UI: 2.71-3.80) million YLLs, 1.87 (95% UI: 1.36-2.45) million YLDs, and a total of 5.10 (95% UI: 4.35-5.84) million DALYs, which is higher than that in 1990 with 75.42 million people with CKD, 119.50 (95% UI: 88.26-158.14) thousand deaths, 3.79 (95% UI: 2.89-4.82) million YLLs, 0.78 (95% UI: 0.57-1.02) million YLDs, 4.57 (95% UI: 3.63-5.64) million DALYs. The mortality and DALYs rates of CKD in 2023 demonstrated significant regional heterogeneity, with a heavier burden being observed in western and southern China. Males and the elderly aged ≥65 years bore a higher mortality and DALYs rates compared to their counterparts. From 1990 to 2023, we discerned a notable escalation in the CKD burden attributed to T2DM and hypertension, but the contribution of glomerulonephritis and T1DM displayed a declining trajectory in deaths, YLLs and DALYs. Despite an increase in the number of CKD-related deaths, YLDs, and DALYs from 1990 to 2023, the age-standardized mortality rate, YLDs rate and DALYs rate of CKD declined by 52.89% (95% UI: 33.72-66.16), 7.94% (95% UI: 0.42%-18.60%), 51.04% (95% UI: 37.58%-60.82%). Causal attribution analysis indicated that hypertension (19.6%), type 2 diabetes mellitus (18.9%), and glomerulonephritis (10.9%) constituted the leading causes for CKD mortality in 2023. Concurrently, the top five risk factors impacting CKD burden across mortality, YLLs, YLDs, and DALYs were high fasting plasma glucose, high systolic blood pressure, dietary risks, high body mass index, and non-optimal temperature.
Interpretation: In the past three decades, the number of people with CKD and its related deaths significantly increased in China, which exhibits a heavy disease burden, with evident population and spatial heterogeneity. Preventing and improving management of kidney function, diabetes and hypertension will be very helpful for reducing CKD burden in China. The findings can assist Chinese government in policymaking of CKD prevention and management.
