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Background <p>Chronic kidney disease (CKD) and its complication, anemia, remain significant public health challenges in China. However, up-to-date estimates of their disease&#xa0;burden remain limited, constraining effective planning and targeted interventions in China.</p> Methods <p>The prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of CKD, together with the prevalence and years lived with disability (YLDs) of anemia attributable to CKD in China from 1990 to 2021, were estimated from the Global Burden of Disease 2021 study, by age, sex, and CKD subtype. We calculated the YLDs to DALYs ratio of CKD, ranked the disease burden in China compared to other countries, conducted decomposition analyses to evaluate subtype-specific and demographic contributions, assessed modifiable risk factors, and performed clustering based on trend&#xa0;of age-standardized rate.</p> Results <p>In 2021, there were 118.40 million [95% uncertainty interval (UI): 109.39, 127.48] individuals with CKD and 3.22 million (95% UI: 3.07, 3.56) new cases in China. CKD accounted for 204.23 thousand (95% UI: 164.74, 246.37) deaths and 6.13 million (95% UI: 5.18, 7.21) DALYs in 2021. While age-standardized prevalence, mortality, and DALYs rates declined, the age-standardized incidence rate increased from 1990 to 2021. Notably, some CKD subtypes and older adults showed rising disease&#xa0;burdens. For CKD-attributable anemia, 8.06 million prevalent cases (95% UI: 7.31, 8.89) and 191.11 thousand (95% UI: 124.98, 274.10) YLDs were recorded in 2021, with declining age-standardized prevalence and YLDs rates since 1990. The YLDs-to-DALYs ratio of CKD in China&#xa0;approached level in high socio-demographic index countries. High fasting plasma glucose, high systolic blood pressure, high body mass index, diet high in sodium, low temperature, and diet low in fruits were identified as leading modifiable&#xa0;risk factors in China. Population aging and CKD due to diabetes&#xa0;mellitus type 2 were primary drivers of the increased disease&#xa0;burden. Clustering analysis placed China alongside countries such as South Korea with similar trends.</p> Conclusion <p>From 1990 to 2021, the age-standardized mortality and DALYs rates for CKD and the age-standardized YLDs rate for CKD-attributable anemia declined in China, whereas the absolute numbers of prevalent and incident CKD cases remained high. To address these challenges, strategies targeting metabolism, diet, and aging-related multimorbidity are needed.</p>

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Trends in the disease burden of chronic kidney disease and anemia attributable to chronic kidney disease in China, 1990–2021

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月17日

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  • Shijie Wu,
  • Tian Si,
  • Zhaoqiang Shi,
  • Ling Wang,
  • Yaxiang Song,
  • Ling Qin,
  • Shu Wang,
  • Hanjie Yu,
  • Dayong Hu,
  • Changbin Li,
  • Ai Peng

摘要

Background

Chronic kidney disease (CKD) and its complication, anemia, remain significant public health challenges in China. However, up-to-date estimates of their disease burden remain limited, constraining effective planning and targeted interventions in China.

Methods

The prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of CKD, together with the prevalence and years lived with disability (YLDs) of anemia attributable to CKD in China from 1990 to 2021, were estimated from the Global Burden of Disease 2021 study, by age, sex, and CKD subtype. We calculated the YLDs to DALYs ratio of CKD, ranked the disease burden in China compared to other countries, conducted decomposition analyses to evaluate subtype-specific and demographic contributions, assessed modifiable risk factors, and performed clustering based on trend of age-standardized rate.

Results

In 2021, there were 118.40 million [95% uncertainty interval (UI): 109.39, 127.48] individuals with CKD and 3.22 million (95% UI: 3.07, 3.56) new cases in China. CKD accounted for 204.23 thousand (95% UI: 164.74, 246.37) deaths and 6.13 million (95% UI: 5.18, 7.21) DALYs in 2021. While age-standardized prevalence, mortality, and DALYs rates declined, the age-standardized incidence rate increased from 1990 to 2021. Notably, some CKD subtypes and older adults showed rising disease burdens. For CKD-attributable anemia, 8.06 million prevalent cases (95% UI: 7.31, 8.89) and 191.11 thousand (95% UI: 124.98, 274.10) YLDs were recorded in 2021, with declining age-standardized prevalence and YLDs rates since 1990. The YLDs-to-DALYs ratio of CKD in China approached level in high socio-demographic index countries. High fasting plasma glucose, high systolic blood pressure, high body mass index, diet high in sodium, low temperature, and diet low in fruits were identified as leading modifiable risk factors in China. Population aging and CKD due to diabetes mellitus type 2 were primary drivers of the increased disease burden. Clustering analysis placed China alongside countries such as South Korea with similar trends.

Conclusion

From 1990 to 2021, the age-standardized mortality and DALYs rates for CKD and the age-standardized YLDs rate for CKD-attributable anemia declined in China, whereas the absolute numbers of prevalent and incident CKD cases remained high. To address these challenges, strategies targeting metabolism, diet, and aging-related multimorbidity are needed.