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. 2025 May;17(5):e70098.
doi: 10.1111/1753-0407.70098.

Global, Regional, and National Prevalence of Chronic Type 2 Diabetic Kidney Disease From 1990 to 2021: A Trend and Health Inequality Analyses Based on the Global Burden of Disease Study 2021

Yujun He  1 , Xiaoyi Wang  1 , Lu Li  1 , Minhui Liu  1 , Yachao Wu  1 , Ru Chen  1 , Jiujie He  2 , Wei Mai  2 , Xiaojun Li  1
Affiliations

Global, Regional, and National Prevalence of Chronic Type 2 Diabetic Kidney Disease From 1990 to 2021: A Trend and Health Inequality Analyses Based on the Global Burden of Disease Study 2021

Yujun He et al. J Diabetes. 2025 May.

Abstract

Background: Diabetic kidney disease (DKD) is a prevalent and severe complication of diabetes that significantly impacts global health and quality of life. Most DKD is attributable to type 2 diabetes; therefore, chronic type 2 DKD warrants further examination.

Objective: To deliver targeted assistance in alleviating the worldwide, regional, and national burden of chronic type 2 DKD, we executed a survey assessing the prevalence of chronic type 2 DKD utilizing the Global Burden of Disease, Injury, and Risk Factors (GBD) database.

Methods: We examined the temporal trends of chronic type 2 DKD prevalence over the past 30 years using the 2021 GBD database, analyzed the trends by population, epidemiological change, and aging, and quantified cross-country health inequalities. Additionally, we forecasted the trend during the subsequent two decades.

Results: In 2021, there were over 107 million cases of chronic type 2 DKD globally, reflecting an 85.11% rise from 58 million cases in 1990. The age-standardized rate (ASR) declined with an estimated annual percentage change of 0.17% per annum. Epidemiological change and population expansion are the primary factors influencing the alterations. The contributions of epidemiological change, population, and aging vary with alterations in the sociodemographic index (SDI). Significant health inequalities were observed across 204 countries and territories, with the slope index of inequality increasing over time. The forecast for the worldwide burden of chronic type 2 DKD from 2020 to 2040 suggests a significant rise in case numbers, while the alterations in ASR remain largely stable.

Conclusions: These findings indicate the significant disease burden of chronic type 2 DKD, necessitating more targeted and effective interventions for its prevention and management.

Keywords: GBD; chronic type 2 diabetic kidney disease; health inequality; prediction; trend.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) The ASR of prevalence of chronic type 2 DKD in 2021. (B) The relative change in case number of prevalence of chronic type 2 DKD from 1990 to 2021. (C) The EAPC of ASR of prevalence of chronic type 2 DKD from 1990 to 2021. ASR, age‐standardized rate; EAPC, estimated annual percentage change.
FIGURE 2
FIGURE 2
Changes in prevalence of chronic type 2 DKD according to population‐level determinants including aging, population growth, and epidemiological change from 1990 to 2021 at the global level and by SDI quintiles (A) and regions (B) stratified by sexes. SDI, sociodemographic index.
FIGURE 3
FIGURE 3
Health inequality regression curves (A) and concentration curves (B) for the prevalence of chronic type 2 DKD from 1990 to 2021 across the world.
FIGURE 4
FIGURE 4
(A) The global change trends of ASR of prevalence of chronic type 2 DKD from 1990 to 2021, and its predicted trends between 2022 and 2042. (B) The global change trends of case number of prevalence of chronic type 2 DKD from 1990 to 2021, and its predicted trends between 2022 and 2042.
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