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. 2025 Jul 9:13:1612300.
doi: 10.3389/fpubh.2025.1612300. eCollection 2025.

Global, regional, and national burdens of chronic kidney disease attributable to high body mass index from 1990 to 2021, with future forecasts up to 2050: a systematic analysis for the global burden of disease study 2021

Jun Ying  1 , Xiaolei Lan  1 , Hanjing Zhou  1 , Hongxia Li  1 , Weixin Sheng  1 , Jian Huang  1
Affiliations

Global, regional, and national burdens of chronic kidney disease attributable to high body mass index from 1990 to 2021, with future forecasts up to 2050: a systematic analysis for the global burden of disease study 2021

Jun Ying et al. Front Public Health. .

Abstract

Background: High body mass index (BMI) is a major modifiable risk factor for the development and progression of chronic kidney disease (CKD) through established mechanisms, including glomerular hyperfiltration and metabolic dysfunction. This study aimed to characterize the global, regional, and national temporal trends in CKD attributable to BMI from 1990 to 2021 and forecast trends up to 2050.

Methods: Data were obtained from the Global Burden of Disease 2021 Study. Deaths and disability-adjusted life years (DALYs) for patients with CKD attributable to a high BMI were analyzed using age-standardized rates. The estimated annual percentage change was then calculated. Attribution was calculated as the product of the population-attributable fractions (PAFs) related to CKD deaths/DALYs and disease burden, with deaths/DALYs as the unit of measurement. Age-period cohort analysis was used to estimate the age, period, and cohort effects. Bayesian age-period-cohort modeling was used to predict the burden of CKD associated with high BMI from 2021 to 2050.

Results: From 1990 to 2021, the burden of CKD attributable to BMI showed an increasing trend. Age-standardized death and DALY rates increased in all Sociodemographic Index regions from 1990 to 2021. At the national level, most countries have exhibited an increase in burden from 1990 to 2021. Among females, the 85-89 age group had the highest number of deaths (28,478), whereas among males, it was the 70-74 age group (25,270). Globally, high BMI is a risk factor for CKD, contributing to 27.3% of deaths. With respect to the age effect, deaths from CKD attributable to high BMI increased with age. The burden of CKD attributable to high BMI generally increases from 2021 to 2050.

Conclusion: The burden of CKD attributable to high BMI increased significantly between 1990 and 2021. The growing global burden demands urgent and mechanistically informed health interventions that target the complex pathophysiology of obesity-related kidney diseases.

Keywords: BAPC model; age-period-cohort; chronic kidney disease; global burden of disease; high body mass index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Trends in CKD attributable to high BMI, ASDR, and age-standardized DALYs rate from 1990 to 2021. CKD, chronic kidney disease; BMI, body mass index; ASDR, age-standardized death rate; DALYs, disability-adjusted life years.
Figure 2
Figure 2
The ASR of CKD attributable to high BMI in 204 countries and territories. (A) Deaths. (B) DALYs. ASR, age-standardized rates; CKD, chronic kidney disease; BMI, body mass index; DALYs, disability-adjusted life years.
Figure 3
Figure 3
The EAPC of CKD attributable to high BMI in 204 countries and territories. (A) Deaths. (B) DALYs. EAPC, Estimated annual percentage change; CKD, chronic kidney disease; BMI, body mass index; DALYs, disability-adjusted life years.
Figure 4
Figure 4
The burden of CKD attributable to high BMI by age and sex in 2021. (A) Prevalence. (B) Deaths. (C) DALYs. CKD, chronic kidney disease; BMI: body mass index; DALYs, disability-adjusted life years.
Figure 5
Figure 5
The burden of CKD attributable to high BMI by age and sex across SDI regions in 2021. (A) Deaths. (B) DALYs. CKD, chronic kidney disease; BMI, body mass index; SDI, socio-demographic index; DALYs, disability-adjusted life years.
Figure 6
Figure 6
Proportion of CKD attributable to high BMI deaths and DALYs in 2021. (A) Deaths. (B) DALYs. CKD, chronic kidney disease; BMI, body mass index; DALYs, disability-adjusted life years.
Figure 7
Figure 7
Age, period, and cohort effects on CKD attributable to high BMI deaths and DALYs during 1990–2021. (A) Deaths. (B) DALYs. CKD, chronic kidney disease; BMI, body mass index; DALYs, disability-adjusted life years.
Figure 8
Figure 8
Future projections of the global burden of CKD attributable to high BMI by sex. (A) Male deaths. (B) Female deaths. (C) Male DALYs. (D) Female DALYs. CKD, chronic kidney disease; BMI, body mass index; DALYs, disability-adjusted life years.
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