Impact of lead exposure on global chronic kidney disease attributable to hypertension: deaths and disability-adjusted life years from 1990 to 2021 and projected trends for 2022–2036

Background Chronic kidney disease (CKD) due to hypertension represents a major global health challenge, with lead exposure exacerbating this burden. Objective This study aims to analyze the global burden of lead-attributable hypertensive CKD from 1990 to 2021 and project trends over the next 15 years. Method Data from the Global Burden of Disease (GBD) 2021 study were utilized, focusing on mortality and disability-adjusted life years (DALYs). Trends were analyzed across 204 countries/territories, categorized into 21 GBD regions and five socio-demographic index (SDI) quintiles. Detailed analyses of case numbers, age-standardized rates (ASRs), age groups, sex differences, and temporal trends were conducted. Pearson correlation analysis was applied to assess the association between SDI and disease burden, frontier analysis was used to evaluate country-specific burden levels, and autoregressive integrated moving average (ARIMA) models were employed to project future trends (2021–2036). Results From 1990 to 2021, global deaths from lead-attributable hypertensive CKD increased from 16,932 to 52,839 (a 212.07% rise), with age-standardized mortality rate increasing from 0.481 to 0.641 per 100,000 (EAPC = 1.05). DALYs rose from nearly 470,000 to 1.17 million (a 150.98% increase), with age-standardized DALYs rate increasing from 11.825 to 13.725 per 100,000 (EAPC = 0.55), with marked regional disparities. Older adults and males bore a heavier burden. The highest burdens were observed in low SDI regions, while high SDI regions had the lowest burdens, with a minor inflection point at an SDI of approximately 0.5. Frontier analysis revealed substantial heterogeneity in disease burden across countries. Projection analyses indicated a potential reduction in disease burden over the next 15 years. Conclusions Addressing lead exposure is critical to mitigating the burden of CKD due to hypertension. Targeted interventions tailored to SDI levels and lessons from frontier-line countries are recommended to achieve equitable burden reduction.