Global and China trends in glomerulonephritis-induced chronic kidney disease: health inequities, risk factors and projections to 2050.

BACKGROUND

Glomerulonephritis-induced chronic kidney disease (CKD) imposes heavy global health and socioeconomic burdens, but regional vs. global data are limited. We assessed its burden, inequalities, projections in China and globally (1990-2021) to inform prevention strategies.

METHODS

Using 2021 Global Burden of Disease data, we analyzed glomerulonephritis-induced CKD indicators: prevalence, incidence, mortality, and disability-adjusted life years. We used advanced methods, including age-period-cohort analysis, decomposition analysis, and Bayesian forecasting to assess temporal trends and health disparities.

RESULTS

From 1990 to 2021, global age-standardized rates (ASRs) of prevalence, incidence, mortality, and DALYs for glomerulonephritis-induced CKD increased. Global age-standardized prevalence (ASPR) rose from 128.55 to 129.94 per 100,000 (1.09%, 95% UI: -0.78% to 2.90%), while China's ASPR fell from 109.57 to 94.21 (-14.02%, 95% UI: -17.31% to -10.29%). Global slope index of inequality and concentration index decreased. In China, all ASRs decreased. Sex and age disparities were evident, with higher mortality observed among older populations. Decomposition analysis revealed population aging and growth as key contributors to increased mortality. Although a continued reduction in China's overall disease burden has been projected for 2050, an increasing incidence among individuals over 45 years was observed. Impaired kidney function, hyperglycemia, high body mass index, and hypertension were identified as major risk factors both globally and in China.

CONCLUSION

Glomerulonephritis-induced CKD remains a considerable global burden, particularly in lower Sociodemographic Index countries. Pronounced age and sex disparities underscore urgency of targeted interventions for high-risk populations in China.