Chronic Kidney Disease Is 9th Leading Cause of Death, Impacting Nearly 800 Million People

With over a million people each suffering from CKD, China led in number of cases, followed by India.

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The number of people with chronic kidney disease (CKD) has surged to almost 800 million globally, with the condition being the ninth leading cause of death, according to a Nov. 7 peer-reviewed study published in The Lancet.

In CKD, kidneys are damaged, becoming incapable of filtering blood as usual. This results in excess fluids and waste being retained in the body, leading to health issues such as heart disease, anemia, low calcium levels, and depression.

The most common causes of CKD among adults are high blood pressure and diabetes, according to the U.S. Department of Health and Human Services. Other reasons include acute kidney injury, severe obesity, infections, taking drugs toxic to the kidneys, certain types of cancers, and kidney stones with complications.

The study aimed to estimate CKD numbers worldwide and looked at data from adults aged 20 and above from 204 nations and territories between 1990 and 2023.

Researchers estimated that in 2023, there were 788 million CKD cases among people who were 20 and older, an over 25 percent jump from 627 million a decade back in 2013 and up by more than 108 percent from 378 million in 1990.

China had the highest number of people with CKD in 2023 at 152 million, followed by India with 138 million, with the United States, Indonesia, Japan, Brazil, Russia, Mexico, Nigeria, Pakistan, Bangladesh, Iran, the Philippines, Vietnam, Thailand, and Turkey all having more than 10 million adults with CKD, said the study.

There were a total of 1.48 million deaths in 2023 worldwide for which CKD was the underlying cause.

“In 2023, CKD was ranked ninth among causes of death,” it said. “Of the other top ten leading causes of death globally, only the rate of deaths due to Alzheimer’s disease and diabetes rose from 1990 to 2023.”

The global prevalence of CKD was 14.2 percent in 2023, which was higher compared to both 2013 and 1990.

Regions such as North Africa, the Middle East, South Asia, sub-Saharan Africa, and Latin America and the Caribbean had the highest CKD prevalence as of 2023.

In contrast, high-income regions were determined to have a lower prevalence of the disease. This group also had the highest prevalence of patients receiving dialysis and transplant treatments.

As for age-standardized mortality rates, the highest rates were seen in El Salvador, Egypt, Tuvalu, Mauritius, Saudi Arabia, Nauru, Nicaragua, Northern Mariana Islands, Marshall Islands, and American Samoa.

In addition to being the ninth leading cause of death in 2023, CKD was also “the seventh leading cause of cardiovascular mortality, behind high systolic blood pressure and dietary risks and ahead of high blood glucose and high BMI, all of which are also CKD risk factors.”

In a Nov. 7 statement, NYU Langone Health, whose researchers were part of the study, said that most people with CKD in the analysis were in the early stages of the condition.

Study co-senior author Josef Coresh said this was an important observation since swift treatment with lifestyle alterations and drugs can prevent these people from needing dramatic and expensive interventions such as a kidney transplant or dialysis.

“Our work shows that chronic kidney disease is common, deadly, and getting worse as a major public health issue,” he said. “These findings support efforts to recognize the condition alongside cancer, heart disease, and mental health concerns as a major priority for policymakers around the world.”

The study was funded by the Gates Foundation, the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, and the U.S. National Kidney Foundation. Several authors declared competing interests, including receiving payments from health care companies.

CKD Prevalence, Symptoms

According to a May 2024 report from the Centers for Disease Control and Prevention, more than one in seven adults in the United States has CKD, with as many as nine in 10 never knowing they have it.

“CKD has varying levels of seriousness. It usually gets worse over time, though treatment has been shown to slow progression. CKD can progress to kidney failure or end-stage kidney disease (ESKD). It also increases the risk of heart disease and stroke,” said the agency.

“When the kidneys stop working, dialysis or kidney transplant is needed for survival. Kidney failure treated with dialysis or kidney transplant is called end-stage kidney disease. Not all people with kidney disease progress to kidney failure.”

As for symptoms, people with CKD may not become ill or even notice any symptoms of the condition, the CDC said. Only blood and urine tests can determine whether a person has CKD or not, it said.

In a September 2023 post, the National Kidney Foundation recommended that people stop smoking or using tobacco products since smoking can speed up the process of kidney disease and raise the risk of kidney failure.

The foundation also recommended exercising regularly, sleeping well, losing weight, and finding ways to reduce or manage stress.

Almost half of American adults have hypertension, a leading cause of CKD, according to an April 21 post by the University of Kentucky.

People who are obese or overweight should consider reducing their weight by 7–10 percent, said the post, adding that this would make a positive impact on their health.