Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
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Résumé
BACKGROUND: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. METHODS: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. FINDINGS: Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, -1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, -1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. INTERPRETATION: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. FUNDING: Bill & Melinda Gates Foundation.
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La notice
- Revue
- The Lancet
- Thématique
- Chronic Kidney Disease and Diabetes
- Domaine
- Medicine
- Établissements canadiens
- —
- Organismes subventionnaires
- National Institute of Diabetes and Digestive and Kidney DiseasesMedicinska Fakulteten, Lunds UniversitetSanofi PasteurNovartis PharmaJohns Hopkins Bloomberg School of Public HealthMedical Research CouncilTufts University School of MedicineArnold School of Public Health, University of South CarolinaUniwersytet OpolskiGeorge Institute for Global HealthAbbott DiagnosticsUniversitair Ziekenhuis AntwerpenLaboratório Associado para a Química VerdeKfH-Stiftung PräventivmedizinJahrom University of Medical SciencesFrankfurt University of Applied SciencesLorestan University of Medical SciencesServierSiemens HealthineersMekelle UniversityPomorski Uniwersytet Medyczny W SzczecinieUniversitas AirlanggaAddis Ababa UniversityResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesUniversity of GondarUniversity of Health and Allied SciencesUniversitatea de Medicină şi Farmacie "Carol Davila" BucureştiUniversität UlmUrmia UniversityInstituto de Salud Carlos IIIArak University of Medical SciencesUniversity of Cape TownSemnan UniversityUniversità degli Studi di SalernoUppsala UniversitetBabol Noshirvani University of TechnologyMedizinische Universität GrazBahir Dar UniversityShahid Beheshti University of Medical SciencesUniversidad Nacional Autónoma de MéxicoUniversidade de São PauloGuilan University of Medical SciencesWestern Sydney UniversityDanmarks Tekniske UniversitetImperial College LondonShiraz UniversityAkademiska SjukhusetKarl-Franzens-Universität GrazUniversidade Federal do Rio Grande do SulBayer VitalFresenius Medical Care North AmericaHaramaya UniversityGolestan University of Medical SciencesNational Research FoundationUniversità di CataniaUniversiti MalayaNovo NordiskVetenskapsrådetShiraz University of Medical SciencesShahroud University of Medical SciencesUniwersytet ŁódzkiKing Abdulaziz UniversityLunds UniversitetAmarin CorporationIslamic Azad UniversityUniversity of HailUniversidade do PortoUniversity of South CarolinaSeoul National UniversityCairo UniversityUniversity of WashingtonHögskolan DalarnaInternational Centre for Diarrhoeal Disease Research, BangladeshWashington University in St. LouisMonash UniversityAdigrat UniversityNorth-West UniversityPublic Health AgencyDebre Markos UniversityUniversität BielefeldPublic Health EnglandPublic Health Foundation of IndiaSouth African Medical Research CouncilComunidad de MadridIstituto di Ricerche Farmacologiche Mario Negri - IRCCSNational Heart Foundation of AustraliaMassachusetts General HospitalUniversity College LondonUniversity of TabrizAhmadu Bello UniversityEuropean CommissionBaki Dövlət UniversitetiSydney Medical SchoolAstraZenecaDeakin UniversityAlnylam PharmaceuticalsUniversidade Federal de Santa CatarinaBaqiyatallah University of Medical SciencesSanjay Gandhi Postgraduate Institute of Medical SciencesUniversity of TorontoUniversità degli Studi di Napoli Federico IIMinistry of Health and Medical EducationMazandaran University of Medical SciencesUniversity of AlbertaKarolinska InstitutetSalahaddin University-ErbilMaragheh University of Medical SciencesFogarty International CenterTrường Đại học Nguyễn Tất ThànhTarbiat Modares UniversityBrown UniversityNational Center of Neurology and PsychiatryOmron HealthcareTehran University of Medical Sciences and Health ServicesFundação para a Ciência e a TecnologiaRede de Química e TecnologiaAksum UniversityCase Western Reserve UniversityInstitute for Health Metrics and EvaluationMinistério da Ciência, Tecnologia e Ensino SuperiorTrường Đại học Duy TânApplied Molecular Biosciences UnitIran University of Medical SciencesAmgenPublic Health Agency of CanadaMahatma Gandhi UniversityRafsanjan University of Medical SciencesU.S. Department of Veterans AffairsJazan UniversityUniversity of OtagoUniversity of New South WalesUniversity of PittsburghNational Institutes of HealthChinese University of Hong KongBabol University of Medical SciencesCleveland ClinicJohns Hopkins UniversityBill and Melinda Gates FoundationHandokPfizerSanofiUniversity of WarwickTabriz University of Medical SciencesAlexion PharmaceuticalsJordan University of Science and TechnologyUniversity of OxfordMcMaster UniversityOttawa Hospital Research InstituteTufts Medical Center
- Mots-clés
- Kidney diseaseMedicineEpidemiologyRenal functionDiseaseDisease burdenMortality rateGoutIncidence (geometry)Intensive care medicineEnvironmental healthInternal medicine
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