[The endemic nature of chronic kidney disease].

Chronic kidney disease (CKD) has been increasingly recognized as a major global health burden, prompting the WHO and UN in 2025 to call for strengthened prevention, early detection, and improved care. CKD accounted for approximately 1.5 million deaths in 2023, with age standardized mortality continuing to rise. Metabolic risk factors, especially hypertension, diabetes, and obesity, are the primary drivers of CKD burden in adults, while environmental and occupational exposures play an additional role in low resource settings. Congenital anomalies, hereditary nephropathies, and early life kidney injury are the main risk determinants in children. CKD of unknown cause (CKDu) represents a distinct public health challenge in agricultural regions of low-income countries, affecting mainly younger adults without traditional risk factors, with heat stress, dehydration, and environmental toxins considered potential contributors.