Global CKD Burden Declines in Children but Continues to Rise Among Young Adults, Study Finds

The global burden of chronic kidney disease (CKD) has followed divergent trajectories over the past three decades, with declining mortality and disability among children but increasing incidence among young adults, according to a new analysis based on data from the Global Burden of Disease (GBD) Study 2021.¹

The findings, published in Frontiers in Public Health, show that from 1990 to 2021, children aged 0 to 14 years experienced significant reductions in CKD-related mortality and disability-adjusted life years (DALYs), while incidence remained relatively stable. In contrast, young adults aged 15 to 39 years saw sustained increases in CKD incidence over the same period, with projections suggesting this upward trend will continue through 2050.¹

The clinical and public health implications of CKD remain substantial. In 2017, CKD affected approximately 850 million individuals worldwide and accounted for 1.2 million deaths. Investigators cited projections suggesting CKD may become the fifth leading cause of death globally by 2040.^1,2

Using GBD 2021 data from 204 countries and territories, investigators assessed global, regional, and sociodemographic index (SDI)–level trends in CKD incidence, mortality, and DALYs. Among children, age-standardized CKD incidence declined modestly from 31.6 cases per 100 000 population in 1990 to 30.6 per 100 000 in 2021, a change that was not statistically significant. However, mortality decreased by 45.1%, and DALYs declined by 43.2% over the same period. The average annual percentage change for mortality and DALYs in children was −1.925 and −1.820, respectively.¹

Among young adults, the pattern was notably different. CKD incidence increased by 33.6%, rising from 27.0 cases per 100 000 population in 1990 to 36.1 per 100 000 in 2021. Although increases in mortality and DALYs were smaller and not statistically significant, trend analyses showed consistent upward trajectories, with an average annual percentage change of 0.941 for incidence. The most rapid growth occurred between 2019 and 2021.¹

Substantial geographic and socioeconomic disparities were observed. In 2021, the highest CKD incidence among children was reported in Central Latin America, Central Asia, and North Africa and the Middle East, while Western Europe and High-Income Asia Pacific had the lowest rates. For young adults, the highest incidence was seen in Central Latin America, Central Asia, and Eastern Europe. Across age groups, regions with higher SDI generally had lower mortality and DALYs, despite sometimes higher incidence.¹

Risk factor analyses highlighted metabolic contributors as key drivers of CKD-related deaths and disability among young adults. High fasting plasma glucose, high body mass index, and high systolic blood pressure accounted for an increasing proportion of attributable risk between 1990 and 2021, particularly in higher-SDI regions. Dietary factors, including low intake of fruits and vegetables and high consumption of processed and red meats, also contributed to CKD burden in certain regions.¹

Forecasting analyses suggest these age-based disparities will persist. By 2050, the global incidence of CKD in children is projected to decline by 17.65% compared with 2021, reaching an estimated incidence rate of 25.20 per 100 000 population. In contrast, CKD incidence among young adults is expected to increase from 36.06 per 100 000 in 2021 to 47.92 per 100 000 in 2050, with the steepest increases projected among individuals aged 30 to 39 years.¹

“Globally, CKD is still a major health problem and is expected to continue increasing over the next two decades, especially among young adults. High SDI regions should remain mindful of the importance of a balanced diet in slowing CKD progression, while the broader society should provide greater attention, support, and resources to low SDI regions,” investigators concluded.¹

References:

1. He Y, Qian Y, Xu Q, Lu Q, Zhang N. Global trends and risk factors of chronic kidney disease in children and young adults from 1990 to 2021: a systematic analysis of the global burden of disease study 2021. Frontiers in Public Health. 2025;13:1696021-1696021. doi:https://doi.org/10.3389/fpubh.2025.1696021
2. Kovesdy CP. Epidemiology of chronic kidney disease: An update 2022. Kidney International Supplements. 2022;12(1):7-11. doi:https://doi.org/10.1016/j.kisu.2021.11.003