Climate change and chronic kidney disease: A global analysis integrating the global burden of disease study 2021 with TerraClimate data.

BACKGROUND

Chronic kidney disease (CKD) is a major and increasingly severe global health challenge. Recent evidence suggests that climate change may influence the burden of CKD. This study aimed to systematically assess the association between climate change and the age-standardized incidence rate (ASIR) of CKD.

METHODS

Data from the Global Burden of Disease (GBD) 2021, the TerraClimate database, and the Coupled Model Intercomparison Project Phase 6 (CMIP6) were integrated to analyze associations between climate factors and CKD burden from 1990 to 2021. ASIRs were stratified by sex, age, socio-demographic index (SDI), latitude, and climate zone. Generalized linear models with multivariable adjustments were applied to assess associations. Future CKD trends were projected until 2100 using autoregressive integrated moving average (ARIMA) models and CMIP6-based scenarios.

RESULTS

From 1990 to 2021, the global ASIR of CKD was 212.10 per 100,000 population (95% UI: 207.48-216.71). A higher burden was observed among females, older adults, populations in high SDI regions, and those living in arid climates. Maximum temperature variability and wind speed were identified as significant risk factors, with each one-unit increase in maximum temperature variability being associated with a 7.4% increase in CKD incidence. Moreover, soil moisture demonstrated a protective effect. Subgroup analyses revealed heterogeneity across age, SDI, and climate zones. Projections under the SSP585 scenario suggested that the global ASIR of CKD could increase by nearly 148.5% by 2100, while ARIMA forecasts showed a continued rise through 2050.

CONCLUSION

Maximum temperature variability and wind speed are independent global drivers of CKD ASIR, exhibiting significantly greater effects in high SDI, arid, and tropical regions. These findings highlight the urgent need to consider kidney health in climate change adaptation strategies. Targeted interventions should be implemented, such as heatwave early warning systems, improved water resource management, and early CKD screening, particularly in vulnerable populations.