Growing global burden of chronic kidney disease due to type 2 diabetes

Type 2 diabetes mellitus (T2DM) has been a primary contributor to the increasing global burden of chronic kidney disease (CKD) over the past couple of decades, a new study has shown.

“We suggest a more-pragmatic approach focusing on early diagnosis, primary care, and adequate follow-up to reduce mortality and the long-term burden in low-to-middle [sociodemographic index (SDI)] regions,” researchers said. “Interventions should address high systolic blood pressure as well as overweight and obesity problems, especially in high-income regions.”

Using data from the Global Burden of Disease study from 1990 to 2017, researchers saw a 74-percent increase in the global incident cases of CKD. In 1990, there were 1,354,548 CKD cases worldwide. By 2017, this number had ballooned to 2,352,496. Related deaths also jumped by 145-percent in 2017 from 1990 figures.

In addition, disability-adjusted life-years (DALYs) attributable to CKD due to T2DM increased by more than twofold, from 3,819,981 DALYs at 1990 to 8,122,240 DALYs at 2017.

Analysis according to SDI showed that while CKD incidence increased in all regions, the spike was greatest in middle SDI countries. The same was true for deaths and DALYs.

The researchers however showed that population growth accounted for majority of the increase in DALYs worldwide, followed by ageing. The effect of ageing was strongest in high-middle-SDI countries and weakest in the lowest SDI quintile.

In terms of risk factors, researchers showed that hypertension accounted for 45.72 percent of the global age-standardized DALYs, while high body mass index (BMI) was responsible for 34.5 percent. The effect of BMI, in particular, increased rapidly over time, particularly in high-SDI countries, where it contributed 33.64 percent of the burden in 1990 and 43.75 percent in 2017.