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. 2025 Apr 2;10(7):2116-2127.
doi: 10.1016/j.ekir.2025.03.051. eCollection 2025 Jul.

Holistic Impact of CKD: A Clinical, Economic, and Environmental Analysis by IMPACT CKD

Naveen Rao  1 , Francisco Brotons-Munto  2 , Ana F Moura  3 , Janwillem W H Kocks  4   5   6   7 , Ming-Hui Zhao  8 , Steven Chadban  9 , Hannah Guiang  10 , Stacey Priest  10 , Stephen Brown  10
Affiliations

Holistic Impact of CKD: A Clinical, Economic, and Environmental Analysis by IMPACT CKD

Naveen Rao et al. Kidney Int Rep. .

Abstract

Introduction: Chronic kidney disease (CKD) is a growing global health problem driven by aging and the rise of comorbidities, including diabetes and hypertension. Although clinical and economic burdens have been reported, there is a lack of information on the multidimensional impact of CKD across countries with varying demographics and health system archetypes.

Methods: The validated IMPACT CKD model was used to project the clinical, health care resource use (HCRU), economic, patient, societal, and environmental burden of CKD in 8 countries (Australia, Brazil, China, Germany, Netherlands, Spain, United Kingdom, and United States) over 10 years (baseline: 2022; simulated years: 2023-2032).

Results: By 2032, 11.7% to 16.5% of the countries' populations were projected to have CKD, with prevalence rising in 7 countries over 10 years, and a shift toward later stages. These increases were accompanied by projected increases of 3.6% to 170.8% and 41.9% to 80.1% in the number of patients living on dialysis and with a functioning kidney transplant, respectively. Driven by this growing clinical burden, increases of over 19% in CKD costs and 20% in kidney replacement therapy (KRT) costs were projected across all countries. Impaired work productivity led to significant projected losses in gross domestic product, full-time equivalents, and tax revenue. Freshwater consumption, fossil fuel depletion, and carbon production in patients on KRT were projected to increase by over 11% in all the countries.

Conclusion: This study demonstrates the multifaceted burden of CKD globally and supports the adoption of policies such as CKD screening programs and public health awareness to promote early diagnosis and treatment to mitigate the growing disease burden.

Keywords: chronic kidney disease; kidney replacement therapy; microsimulation epidemiology model; multidimensional burden; policy.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Countries included in the IMPACT CKD microsimulation.
Figure 2
Figure 2
Change in country population, number of patients with CKD, receiving dialysis, and living post-transplant from 2022 to 2032. CKD, chronic kidney disease; UK, United Kingdom; US, United States.
Figure 3
Figure 3
Change in health care resource use from 2022 to 2032. ER, emergency room; UK, United Kingdom; US, United States.
Figure 4
Figure 4
Change in CKD stage 1-5 (non-KRT) and KRT costs from 2022 to 2032. CKD, chronic kidney disease; KRT, kidney replacement therapy; UK, United Kingdom; US, United States.
Figure 5
Figure 5
Change in environmental burden in KRT patients from 2022 to 2032. KRT, kidney replacement therapy; UK, United Kingdom; US, United States.
See this image and copyright information in PMC

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