Global, Regional, and National Burden of CKD due to Glomerulonephritis from 1990 to 2019: A Systematic Analysis from the Global Burden of Disease Study 2019

Abstract

Background: CKD is becoming a major human health concern. Limited quantitative assessments of the burden of CKD due to glomerulonephritis have been performed. We performed a comprehensive analysis of the disease burden to update the epidemiology of this disease.

Methods: Incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) data and percent changes in these indicators were extracted from Global Burden of Disease Study 2019 to analyze the burden of CKD due to glomerulonephritis.

Results: Globally, there were 606,300 (95% uncertainty interval [UI], 560,100 to 658,100) incident patients, 17,300,000 (95% UI, 16,100,000 to 18,600,000) prevalent patients, 183,700 (95% UI, 146,300 to 228,900) deaths, and 6,900,000 (95% UI, 5,900,000 to 8,100,000) DALYs of CKD due to glomerulonephritis in 2019. Compared with those in 1990, the numbers of incident patients, prevalent patients, deaths, and DALYs increased by 77%, 81%, 100%, and 66%, respectively. Most of the disease burden was concentrated in countries with lower sociodemographic index. In Central Latin America, the disease burden was much higher than expected on the basis of its sociodemographic index. Decomposition analysis showed that population aging and growth were the two major drivers of the increase in DALYs. Frontier analysis revealed considerable opportunities to reduce the age-standardized DALYs in the middle of the sociodemographic-index spectrum. Although middle-aged and elderly individuals accounted for the majority of the disease burden, the highest incidence rate was observed in children aged 1-4 years.

Conclusions: The disease burden of CKD due to glomerulonephritis has increased worldwide, especially in regions and countries with lower sociodemographic indexes.

Graphical abstract

Figure 1

Worldwide burden of CKD due to glomerulonephritis. Age-standardized incidence (A), prevalence (B), deaths (C), and DALYs (D) rates per 100,000 population in 2019 of CKD due to glomerulonephritis in 204 countries and territories. DALYs, disability-adjusted life-years.

Figure 2

Age and sex patterns of the global burden of CKD due to glomerulonephritis. Global incidence (A), prevalence (B), deaths (C), and DALYs (D) rates per 100,000 people and their corresponding 95% uncertainty interval in 2019 of CKD due to glomerulonephritis by sex and age.

Figure 3

Burden of CKD due to glomerulonephritis in five sociodemographic-index quintiles. The temporal trends of global age-standardized incidence (A), prevalence (B), deaths (C), and DALYs (D) rates per 100,000 people from 1990 to 2019 of CKD due to glomerulonephritis in different sociodemographic-index quintiles.

Figure 4

Correlations between burden of CKD due to glomerulonephritis and the sociodemographic index. Age-standardized incidence (A), prevalence (B), deaths (C), and DALYs (D) rates per 100,000 population of CKD due to glomerulonephritis in 21 regions, by sociodemographic-index, 1990–2019. Black line and gray ribbon represent expected values of each disease rate and its corresponding 95% confidence interval on the basis of the sociodemographic index in all locations.

Figure 5

Change in DALYs of CKD due to glomerulonephritis decomposed by three population-level determinants: population aging, population growth, and epidemiological change from 1990 to 2019 at the global level and five sociodemographic-index quintiles. The black dots indicate the total value of change attributable to all three components.

Figure 6

Frontier analysis on the basis of sociodemographic-index and age-standardized DALYs per 100,000 of CKD due to glomerulonephritis from 1990 to 2019. The frontier line is delineated in black, indicating the potentially achievable age-standardized DALYs on the basis of sociodemographic-index; dots represent the actual age-standardized DALYs in every country and territory. Color scale represents the years from 1990 depicted in dark blue to 2019 in light blue. (A) Frontier analysis on the basis of sociodemographic-index and age-standardized DALYs per 100,000 of CKD due to glomerulonephritis in 2019. The increase in age-standardized DALYs from 1990 to 2019 is shown in red dots, whereas the decrease in green dots. The frontier line, representing the potentially achievable age-standardized DALYs on the basis of sociodemographic-index, is portrayed in black. The top 15 countries with the highest effective difference are labeled in black; the top five countries with the lowest effective difference in low sociodemographic index (<50) are labeled in blue, whereas the highest effective difference in high sociodemographic index (>85) are labeled in red (B).