Comprehensive epidemiological analysis of chronic kidney disease in adolescents and young adults (ages 10-24 years) from 1990 to 2021.

objectivesThe burden of chronic kidney disease (CKD) is increasing globally, with significant variations in disease levels and trends across different countries and regions. Currently, despite a wealth of research reporting data on adult and paediatric populations, there has been a lack of in-depth focus on the burden of CKD in adolescents and young adults (AYA). We aim to assess the global prevalence of CKD among AYA.

designWe implemented a cross-sectional study. DATA SOURCES: A systematic retrieval of data was conducted from the Global Burden of Disease (GBD) database, primarily using the most recent updated information from 2021. DATA EXTRACTION AND SYNTHESIS: We used GBD data and methodologies to characterise the changes in CKD burden among AYA, including incidence rates, death rates and disability-adjusted life years (DALYs). Additionally, we employed decomposition analysis, frontier analysis and health inequality analysis to investigate the prevalence of CKD in countries or regions with varying levels of socioeconomic development.

resultsOn a global scale, between 1990 and 2021, the number of AYA with CKD increased from 232025.4 (95% UI 153243.5-323838.5) in 1990 to 387070.1 (95% UI 287311.6-508428.3) in 2021. For AYA, the primary causes of CKD are other and unspecified causes (congenital anomalies of the kidney and urinary tract, etc), followed by glomerulonephritis. Over the past 30 years, the decline in CKD burden among AYA has been most significant in countries like China, Japan, South Korea, Spain, Portugal, Russia, France and Italy. In contrast, the countries or regions with the fastest-growing CKD burden are Somalia, Mozambique, Chad, Uganda, Niger and Angola in sub-Saharan Africa, followed by Afghanistan, Saudi Arabia, Yemen, Iraq and Pakistan in the Middle East or South Asia. Despite improvements over the decades, the burden of CKD among AYA remains concentrated in low-income countries and populations with poorer economic conditions.

conclusionFrom 1990 to 2021, the death and DALYs burden of CKD among AYA globally remained relatively stable, but the incidence rate is steadily increasing. AYA in sub-Saharan Africa, the Middle East and parts of South Asia tolerate the highest burden, particularly in countries with lower socioeconomic status. To prevent worsening inequalities associated with socioeconomic development, there is an emphasis on the importance of increasing investments in kidney health for AYA in low-income countries.