Health time bomb: Study says India recorded 138 million kidney disease cases in 2023, 2nd worst globally  

The number of adults living with CKD has more than doubled since 1990, reaching nearly 800 million worldwide, according to new research published in The Lancet.

The findings come from the Global Burden of Disease (GBD) 2023 study, which tracked CKD trends among adults age 20 years and older across 204 countries and territories from 1990 through 2023.

The study was led by researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, the New York University Grossman School of Medicine, and the University of Glasgow.

Drawing on 2,230 data sources, the analysis offers the most comprehensive assessment to date of the fatal and non-fatal burden of CKD worldwide.  

The study observed that chronic kidney disease is one of the only leading causes of death, still on the rise.

CKD was the ninth-leading cause of death globally in 2023, claiming nearly 1.5 million lives, and the 12th-leading cause of disability.

Unlike most other leading causes of death, the global age-standardised mortality rate from CKD increased, from 24.9 per 100,000 in 1990 to 26.5 per 100,000 in 2023.  

"China and India, with some of the world’s largest populations, have the highest numbers of people affected by CKD, at 152 million and 138 million," the study said.

But the disease is widespread, with the United States, Indonesia, Japan, Brazil, Russia, Mexico, Nigeria, Pakistan, Bangladesh, Iran, the Philippines, Vietnam, Thailand, and Turkey each reporting more than 10 million adults living with CKD.

“Chronic kidney disease is a growing global health crisis, yet much of its impact is preventable. Reducing deaths is essential to meeting the WHO target of cutting premature mortality from non-communicable diseases by one-third before 2030,” said Lauryn Stafford, co-author author and researcher at IHME.

Chronic kidney disease is a major risk factor for cardiovascular mortality.

The study also highlights CKD as a major contributor to cardiovascular disease and points to the risk factors driving its rise.

In 2023, kidney dysfunction accounted for almost 12% of global cardiovascular deaths, ranking seventh among risk factors for cardiovascular mortality, ahead of diabetes and obesity.

The study identified 14 detailed risk factors for CKD, with diabetes, high blood pressure, and obesity driving the greatest loss of healthy years of life.

Dietary factors, such as low fruit and vegetable intake and high sodium consumption, also made substantial contributions.

“Chronic kidney disease is both a major risk factor for other leading causes of health loss and a significant disease burden in its own right. Yet, it continues to receive far less policy attention than other non-communicable diseases, even as its impact grows fastest in regions already facing the greatest health inequities,” said Dr. Theo Vos, Professor Emeritus at IHME and one of the study’s senior authors.

Chronic kidney disease burden and kidney replacement therapy access remain highly uneven across regions worldwide.

The rising prevalence of obesity and diabetes, together with global population aging, is driving a growing burden of the disease. In 2023, the global age-standardized prevalence of CKD was around 14% among adults aged 20 years and older. The highest prevalence was found in North Africa and the Middle East (18.0%), South Asia (15.8%), sub-Saharan Africa (15.6%), and Latin America and the Caribbean (15.4%). Countries with the highest prevalence included Iran, Haiti, Panama, Nigeria, Mauritius, Seychelles, Grenada, Mexico, Libya, and Costa Rica.

In 2023, most people with CKD were in the early stages of the disease (stages 1-3). This highlights the importance of screening programs and risk-reducing strategies, including more accessible treatments to control blood sugar and blood pressure. These approaches can reduce excess cardiovascular mortality and delay the need for costly kidney replacement therapies in advanced stages of the disease.  

Because access to kidney replacement therapies including dialysis and transplantation remains limited and uneven worldwide, greater emphasis is needed on preventing disease progression and ensuring equitable care.

Expanding access to diagnosis and affordable care, tackling key risk factors, and investing in strategies that slow disease progression will be essential to lessen the growing toll of CKD on patients, families, and health systems worldwide.