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. 2025 Apr;17(4):e70084.
doi: 10.1111/1753-0407.70084.

Trends and Disparities in the Burden of Chronic Kidney Disease due to Type 2 Diabetes in China From 1990 to 2021: A Population-Based Study

Yifei Wang  1   2 , Shiya Gu  1   2 , Zhixuan Xie  3   4 , Zhiyong Xu  5 , Wenfang He  1   2 , Yexiang Chen  6 , Juan Jin  1   2 , Qiang He  1   3
Affiliations

Trends and Disparities in the Burden of Chronic Kidney Disease due to Type 2 Diabetes in China From 1990 to 2021: A Population-Based Study

Yifei Wang et al. J Diabetes. 2025 Apr.

Abstract

Background: This study analyzes the trends in the burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in China from 1990 to 2021, evaluates variations in risk factors, and projects the disease burden through 2036.

Method: Estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for CKD-T2D were retrieved along with their 95% uncertainty intervals (UIs). Age-period-cohort analysis was used to assess burden trends from 1990 to 2021, identify risk factor population attributable fractions (PAFs), and project the burden through 2036.

Results: In 2021, there were 20 911 520 CKD-T2D cases in China, with an age-standardized prevalence rate (ASPR) of 1053.92 per 100 000, an incidence rate (ASIR) of 23.07, an age-standardized mortality rate (ASMR) of 5.72, and an age-standardized DALY rate (ASDR) of 122.15. Although the overall burden showed a slow decline from 1990 to 2021, incidence continued to rise. The 2021 data revealed a marked age effect, with the burden rising with age. Period effects also contributed to an increased risk, with metabolic risk factors such as high fasting plasma glucose and BMI contributing the most. Projections suggest a decline in mortality and DALYs by 2036, while incidence will keep increasing.

Conclusion: Despite declines in ASMR and ASDR, CKD-T2D incidence and cases continue to rise, especially among males and the elderly. This increasing burden is driven by aging and metabolic risk factors. Early screening, education, and risk management are essential for addressing CKD-T2D in China.

Keywords: China; chronic kidney disease due to type 2 diabetes mellitus; disease burden; risk factors; trends.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Gender and age structure analysis of the burden of CKD‐T2D in China, 2021. (A) Prevalence; (B) incidence; (C) mortality; (D) DALYs.
FIGURE 2
FIGURE 2
Prevalence, incidence, mortality, and DALYs by age group: trends from 1990 to 2021. (A) Prevalence rates; (B) incidence rates; (C) deaths rates; (D) DALYs rates.
FIGURE 3
FIGURE 3
Joinpoint regression analysis of CKD‐T2D burden trends in China. (A) The joinpoint regression analysis on the case number of prevalence; (B) the joinpoint regression analysis on the ASR of prevalence; (C) the joinpoint regression analysis on the case number of incidence; (D) the joinpoint regression analysis on the ASR of incidence; (E) the joinpoint regression analysis on the case number of deaths; (F) the joinpoint regression analysis on the ASR of deaths; (G) the joinpoint regression analysis on the case number of DALYs; (H) the joinpoint regression analysis on the ASR of DALYs; of CKD‐T2D in China.
FIGURE 4
FIGURE 4
The effects of age, period, and birth cohort on the relative risk of CKD‐T2D. (A) Prevalence and (B) incidence.
FIGURE 5
FIGURE 5
Impact of different risk factors on DALYs at different age groups in 2021.
FIGURE 6
FIGURE 6
Attributable risk factors for DALYs in 1990 and 2021.
FIGURE 7
FIGURE 7
Predicted trends of CKD‐T2D burden to 2036. (A) The predicted case number and ASR of prevalence to 2036; (B) the predicted case number and ASR of incidence to 2036; (C) the predicted case number and ASR of mortality to 2036; (D) the predicted case number and ASR of DALYs to 2036.
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References

    1. US Department of Health and Human Services CfDCaP , “National Diabetes Statistics Report,” 2020, https://www.cdc.gov/diabetes/pdfs/data/statistics/national‐diabetes‐stat....
    1. Levey A. S., Eckardt K.‐U., Dorman N. M., et al., “Nomenclature for Kidney Function and Disease: Executive Summary and Glossary From a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference,” American Journal of Kidney Diseases 76, no. 2 (2020): 157–160. - PubMed
    1. Alicic R. and Nicholas S. B., “Diabetic Kidney Disease Back in Focus: Management Field Guide for Health Care Professionals in the 21st Century,” Mayo Clinic Proceedings 97, no. 10 (2022): 1904–1919. - PubMed
    1. Levin A., Tonelli M., Bonventre J., et al., “Global Kidney Health 2017 and Beyond: A Roadmap for Closing Gaps in Care, Research, and Policy,” Lancet 390, no. 10105 (2017): 1888–1917. - PubMed
    1. Saran R., Robinson B., Abbott K. C., et al., “US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States,” American Journal of Kidney Diseases 73, no. 3 (2019): A7–A8. - PMC - PubMed