A groundbreaking study published in The Lancet reveals that a record 788 million people worldwide experienced kidney function decline in 2023, nearly doubling from 378 million in 1990 and establishing chronic kidney disease (CKD) as a leading global cause of death.
This comprehensive analysis—conducted by researchers from NYU Langone Health, University of Glasgow, and the Institute for Health Metrics and Evaluation (IHME)—represents the most extensive assessment of CKD trends in nearly a decade, providing critical insights for addressing this growing public health crisis.
Epidemiological Trends and Mortality Burden
The investigation, part of the 2023 Global Burden of Disease (GBD) study, analyzed data from 133 countries and 2,230 research publications.
Findings indicate approximately 14% of adults worldwide now live with CKD, with the condition causing 1.5 million deaths in 2023—a 6% increase since 1993 after age-adjustment. CKD also ranked as the 12th leading cause of disability-related quality-of-life reduction, highlighting its substantial impact on global health systems.
Risk Factors and Comorbidity Connections
The research identified hyperglycemia, hypertension, and high body mass index as primary drivers of kidney disease progression. Importantly, the study established CKD as a significant cardiovascular risk factor, accounting for approximately 12% of global cardiovascular mortality.
“Impaired kidney function doesn’t just directly cause deaths—it’s a crucial risk factor for heart disease,” explained Dr. Josef Coresh, senior author and population health professor at NYU Grossman School of Medicine.
Diagnostic Gaps and Geographic Disparities
The study uncovered substantial inequities in CKD management worldwide. While most affected individuals are in early disease stages where intervention could prevent progression, diagnostic underdetection remains widespread.
Treatment access varies dramatically by region, with sub-Saharan Africa, Southeast Asia, and Latin America showing particularly low rates of dialysis and transplantation—due partly to limited availability and affordability of these interventions.
Clinical Implications and Intervention Opportunities
“Chronic kidney disease remains underdiagnosed and undertreated,” said co-lead author Dr. Morgan Grams, professor of medicine at NYU Grossman. ”
Our findings emphasize the need for expanded urine testing for early detection and ensuring affordable treatment access post-diagnosis.” The research highlights that most CKD patients are in early stages where lifestyle modifications and medication can avoid need for dialysis or transplantation.
Policy Recommendations and Future Directions
With the World Health Organization recently adding CKD to its 2030 agenda targeting a one-third reduction in premature noncommunicable disease mortality, this research provides essential baseline data.
Researchers urge policymakers to strengthen CKD surveillance systems, expand access to newer disease-slowing medications, and address underlying risk factors like diabetes and hypertension. As global populations continue aging, these findings underscore the urgency of coordinated international action to curb the growing kidney disease epidemic.
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