Global, regional, and National Burden of chronic kidney disease attributable to dietary risks from 1990 to 2021

Abstract

Background: Dietary risks are increasingly reported as a cause of chronic kidney disease (CKD). However, the trends in the burden of CKD attributable to dietary risks have yet to be fully elucidated.

Methods: This study extracted two major indicators related to CKD caused by dietary risks from the Global Burden of Disease (GBD) database for the years 1990 to 2021, including deaths and disability-adjusted life years (DALYs). It used estimated annual percentage change (EAPC) and percentage change to assess the trends in the burden of CKD caused by dietary risks. The relationship between Socio-demographic Index (SDI) and disease burden was also further analyzed. Additionally, we utilized the contemporary age-period-cohort model from NORDPRED to project future burden of CKD attributable to dietary risks.

Results: In 2021, globally, the number of deaths due to CKD caused by dietary risks was 317,010, and the number of DALYs was 7,971,281, approximately 2-3 times that of 1990, and it was expected to continue to rise before 2040. The global death rates and DALY rates of CKD related to dietary risks had increased, with EAPCs of 0.63 (95% CI: 0.57 to 0.69) and 0.39 (95% CI: 0.35 to 0.42), respectively. From a gender perspective, men were more likely to suffer from CKD due to dietary risks. From an age pattern perspective, in 2021, the number of deaths due to CKD caused by dietary risks peaked among men aged 70-74 and women aged 85-89. Additionally, the highest number of DALYs due to CKD caused by dietary risks was observed among men and women aged 65-69. In terms of socioeconomic factors, from 1990 to 2021, as the SDI increased, the age-standardized death rates and DALY rates due to CKD caused by dietary risks generally decreased. Among the seven dietary habits related to dietary risks, low vegetable intake, low fruit intake, and high sodium intake had the greatest impact.

Conclusion: In summary, over the past 32 years, the burden of CKD attributable to dietary risks has rapidly increased globally, and it is expected to continue rising until 2040. Therefore, interdisciplinary actions involving education, policy, and healthcare should be taken to mitigate this growing trend.

Keywords: CKD; DALYs; deaths; dietary risks; disease burden.

Figure 1

Temporal trends in CKD burden attributable to dietary risks across global, 5 SDI regions, and 21 GBD regions. (A) Percentage change in cases of deaths and DALYs from 1990 to 2021. (B) The EAPC in death rates and DALY rates from 1990 to 2021. CKD, Chronic kidney disease; DALYs, Disability-Adjusted Life Years; SDI, Socio-demographic Index; ASR, Age-standardized rate; EAPC, Estimated annual percentage change.

Figure 2

Temporal trends in CKD burden attributable to dietary risks in 204 countries. (A) The ASMR of CKD attributable to dietary risks across 204 countries in 2021. (B) The ASDR of CKD attributable to dietary risks across 204 countries in 2021. (C) The EAPC in ASMR across 204 countries from 1990 to 2021. (D) The EAPC in ASDR across 204 countries from 1990 to 2021. CKD, Chronic kidney disease; SDI, Socio-demographic index; EAPC, Estimated annual percentage change; ASMR, Age-standardized mortality rate; ASDR, Age-standardized disability-adjusted life years rates.

Figure 3

The burden of CKD attributable to dietary risks by age and sex. (A) Age-specific numbers and rates of CKD deaths attributable to dietary risk by sex, in 2021. (B) Age-specific numbers and rates of CKD DALYs attributable to dietary risk by sex, in 2021. (C) The age distribution of the trends in CKD-related death rate attributable to dietary risk from 1990 to 2021 by location (EAPC in death rate). (D) The age distribution of the trends in CKD-related DALY rates attributable to dietary risk from 1990 to 2021 by location (EAPC in DALY rates). CKD, Chronic kidney disease; DALYs, Disability-adjusted life years; SDI, Socio-demographic index; EAPC, Estimated annual percentage change.

Figure 4

Correlations of ASMR as well as ASDR of CKD attributable to dietary risks and SDI at the regional and national level. (A) The ASMR of CKD attributable to dietary risks and SDI at the regional level in 21 regions from 1990 to 2021. (B) The ASMR of CKD attributable to dietary risks and SDI at the national level in 204 countries in 2021. (C) The ASDR of CKD attributable to dietary risks and SDI at the regional level in 21 regions from 1990 to 2021. (D) The ASDR of CKD attributable to dietary risks and SDI at the national level in 204 countries in 2021. CKD, Chronic kidney disease; SDI, The Socio-demographic index; ASDR, Age-standardized disability-adjusted life years rate; ASMR, Age-standardized mortality rate.

Figure 5

Correlation between EAPC of ASMR and EAPC of ASDR with SDI in 2021. (A) The correlation between EAPC in ASMR and SDI in 2021. (B) The correlation between EAPC in ASDR and SDI in 2021. ASMR, Age-standardized mortality rate; ASDR, Age-standardized disability-adjusted life years rate; EAPC, Estimated annual percentage change; SDI, Socio-demographic index.

Figure 6

Observed and predicted trends of burden for CKD attributable to dietary risks globally from 1990 to 2040 using the NORDPRED Model. (A) Number of deaths and ASMR of CKD attributable to dietary risks from 1990 to 2040. (B) Number of DALYs and ASDR of CKD attributable to dietary risks from 1990 to 2040. CKD, Chronic kidney disease; DALYs, Disability-adjusted life years; ASDR, Age-standardized disability-adjusted life years rate; ASMR, Age-standardized mortality rate.