6 Minutes
A major global analysis shows chronic kidney disease (CKD) has quietly surged to affect nearly 800 million people worldwide. Once overlooked in public-health planning, impaired kidney function is now among the top ten causes of death and imposes a growing burden on health systems, particularly in low- and middle-income countries.
What the new data reveal
Researchers working with the Global Burden of Disease (GBD) 2023 consortium report that the number of people living with reduced kidney function rose from about 378 million in 1990 to roughly 788 million in 2023. That jump reflects population growth and global aging, but it also signals rising prevalence of the disease’s key drivers: diabetes, high blood pressure, and obesity.
The study—conducted by teams at NYU Langone Health, the University of Glasgow, and the Institute for Health Metrics and Evaluation at the University of Washington and published in The Lancet—synthesized 2,230 research papers and national health datasets from 133 countries. Its headline findings are stark: chronic kidney disease now ranks within the ten leading causes of death worldwide, and in 2023 approximately 1.5 million deaths were directly attributable to CKD.
Why kidney disease is under the radar
Kidneys decline slowly. Early-stage CKD is often asymptomatic—people can feel fine while blood filtration rates slip. That quiet progression helps explain chronic underdiagnosis: routine urine or blood tests needed to detect early kidney damage are not universally available or prioritized in many clinical settings.
“Our work shows that chronic kidney disease is common, deadly, and getting worse as a major public health issue,” said Josef Coresh, MD, PhD, director of NYU Langone’s Optimal Aging Institute. The authors estimate roughly 14% of adults worldwide now live with CKD. When kidney function drops further, patients may face dialysis, transplant, or premature death—outcomes that strain both families and health systems.
CKD’s ripple effects on heart health and disability
Beyond deaths directly ascribed to kidney failure, impaired renal function is a powerful risk factor for cardiovascular disease. The GBD analysis attributes about 12% of global cardiovascular mortality to reduced kidney function. The condition also ranked 12th globally for years lived with disability in 2023, underscoring how CKD erodes quality of life as well as longevity.
Major modifiable risks
- High blood sugar (diabetes)
- High blood pressure (hypertension)
- High body mass index (overweight and obesity)
Targeting these risk factors—through better diabetes care, blood-pressure control, weight management, and smoking cessation—can reduce the incidence and progression of kidney disease. The good news: many cases are detectable early, and early interventions are much less costly and invasive than dialysis or transplantation.
Unequal access to lifesaving care
The report highlights striking global disparities. In wealthier countries, more people who progress to kidney failure receive dialysis or transplants. In many parts of sub-Saharan Africa, Southeast Asia, and Latin America, dialysis and transplant capacity is limited or unaffordable, meaning many patients who need these treatments do not receive them.
“Chronic kidney disease is underdiagnosed and undertreated,” said Morgan Grams, MD, PhD, co-lead author and professor at NYU Grossman School of Medicine. She emphasized the need for wider urine and blood testing to identify CKD early, and for health systems to ensure affordable access to therapies once patients are diagnosed.
Treatment advances and remaining gaps
Medical advances in the last five years have provided new tools to slow CKD progression and reduce cardiovascular risk. For example, SGLT2 inhibitors—a class of glucose-lowering drugs—have shown benefit in slowing kidney decline even in people without diabetes. Still, uptake of these therapies is uneven globally due to cost, regulatory approval timelines, and availability in primary-care settings.
Scaling up preventive care (screening, blood-pressure control, diabetes management), expanding access to newer medications, and building affordable dialysis and transplant infrastructure in low-resource settings are key policy priorities. The World Health Organization has included CKD in its strategy to reduce premature deaths from noncommunicable diseases, a recognition of how kidney health intersects with broader global health goals.
Expert Insight
Dr. Elena Ruiz, a nephrologist and global health researcher, offers a practical view: “Detection is the low-hanging fruit—simple urine tests and estimated glomerular filtration rate (eGFR) calculations can identify most patients at risk. If health systems prioritize screening in diabetes and hypertension clinics, we can prevent many people from ever needing dialysis.”
She adds that community-level interventions—education on salt reduction, affordable hypertension medicines, and early referral pathways—are among the highest-impact, cost-effective steps countries can take.
Policy implications and next steps
For policymakers, the report is a call to action: treat CKD with the same urgency as other major noncommunicable diseases such as cancer and heart disease. Investments in primary care, universal access to essential medicines, and equitable dialysis and transplant programs will be critical. Researchers and public-health agencies also need better data from underrepresented regions to refine burden estimates and tailor interventions.
The GBD 2023 findings are already influencing agenda-setting at global health forums and will likely shape national strategies in the coming years. For individuals, the message is simple: manage blood sugar, maintain healthy blood pressure, watch weight, and ask clinicians for routine kidney screening if you have risk factors. Early detection saves lives and spares health systems enormous future costs.
Source: scitechdaily
Comments
labcore
wow, nearly 800M? That’s terrifying. CKD quietly creeping, and poorest countries get hit hardest. Need cheap screening, asap…
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