Key result
CKD mortality in adults 75 and older rises ~54% between 1990 and 2021.
Why the study?
Previous studies examined CKD across the entire age spectrum, leaving a gap in understanding unique epidemiological patterns and trends specifically among adults aged 75 years and over.
Observational (n=288,520,255)
Yes
Effect estimate: EAPC 1.55% (95% CI 1.48%-1.61%)
Absolute Event Rate: 246.9% vs 160.55%
The global burden of CKD in adults aged 75 and older is shifting towards high incidence, mortality, and disability, despite a slight decline in age-standardized prevalence from 1990 to 2021.
First global CKD burden estimates in adults ≥75 years; leaves open targeted strategies pending prospective validation.
BACKGROUND: Drawing on data from the Global Burden of Disease (GBD) 2021 study, this research provides the first systematic assessment of the burden and trends of chronic kidney disease (CKD) among the global population aged 75 years and over between 1990 and 2021. Unlike previous studies covering the entire age spectrum, this study focuses on the age group with the highest concentration of disease burden and the greatest health vulnerability, with the aim of revealing the unique epidemiological patterns specific to this population. METHODS: The study methodology involved extracting data on the prevalence, incidence, mortality and disability-adjusted life years (DALYs) for chronic kidney disease (CKD) among people aged 75 years and over in 204 countries and territories from the GBD 2021 database. All reported rates are age-standardized. We calculated estimated annual percentage changes (EAPCs) to analyze trends and examined the association between the disease burden and the Sociodemographic Index (SDI). RESULTS: The study found that in 2021, approximately 127 million people aged 75 years and over worldwide were living with CKD. Between 1990 and 2021, the age-standardized prevalence declined slightly (EAPC = -0.06%; 95% UI: -0.09% - -0.03%), whilst incidence, mortality and DALY rates all rose significantly (EAPCs of 0.50%; 95% UI: 0.47%-0.53%, 1.55%; 95% UI: 1.48%-1.61% and 1.07%; 95% UI: 1.02%-1.12%, respectively), demonstrating the key phenomenon of 'prevalence-mortality trend divergence'. The relationship between the burden of disease and socio-economic development is complex: regions with low SDI bear the heaviest burden of mortality, whilst regions with high SDI have experienced the fastest growth in mortality rates. The study also revealed significant heterogeneity in the burden across age, gender and geographical regions. CONCLUSIONS: The burden of chronic kidney disease (CKD) among the global older adult population is rapidly shifting from a pattern of 'high prevalence' to one characterised by 'high incidence, high mortality and high disability', with the underlying drivers exhibiting fundamental differences across regions at various stages of development. This necessitates that public health strategies move beyond a 'one-size-fits-all' approach and instead develop highly age-specific and contextually tailored interventions. This study provides a detailed map for understanding the epidemiology of CKD in the context of extreme population ageing, and offers crucial evidence for the allocation of resources and the formulation of policies.
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Wang et al. (2026) conducted an observational in Chronic kidney disease (n=288,520,255). Time period (1990-2021) vs. 1990 baseline was evaluated on Age-standardized mortality rate per 100,000 population (EAPC 1.55%, 95% CI 1.48%-1.61%). Between 1990 and 2021, the age-standardized mortality rate of chronic kidney disease in adults aged 75 and older increased significantly from 160.55 to 246.90 per 100,000 (EAPC 1.55%).
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