Global, regional and national burden of hypertension-associated chronic kidney disease attributable to high and low temperature from 1990 to 2021 and projections to 2050: a finding from the Global Burden of Disease Study 2021.

INTRODUCTION: Chronic kidney disease (CKD), particularly hypertension-associated CKD (HCKD), is a significant global health burden, with hypertension and diabetes as leading causes. Rising global temperatures and climate variability exacerbate HCKD risks by triggering mechanisms like dehydration, renal ischemia, and increased blood pressure. Using Global Burden of Disease (GBD) 2021 data and predictive models, this study examines trends in HCKD attributable to high and low temperatures. METHOD: This study utilizes GBD 2021 data, focusing on HCKD burden from temperature extremes. Age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years rates (ASDR) were analyzed using descriptive statistics and trend evaluations through estimated annual percentage change (EAPC). Forecasts employed the exponential smoothing (ES) and autoregressive integrated moving average (ARIMA) models. P <0.05 is considered statistically significant, with uncertainty intervals enhancing robustness. RESULT: In 2021, 5,013 (95% UI: -117-12,053) deaths and 117,175 (95% UI: 4,333-270,676) DALYs from HCKD attributable to high temperature were recorded worldwide, with increases in ASMR (EAPC: 3.43) and ASDR (EAPC: 3.18) since 1990. Low temperature caused 22,892 deaths and 420,310 DALYs, with slower ASMR and ASDR growth. Men consistently exhibited higher ASMR and ASDR than women. Mortality and burden peaked in the 95+ age group and varied across SDI regions, with the highest burdens in low-SDI areas. ARIMA and ES models project continued growth in HCKD burden due to temperature, though growth rates may decelerate by 2050. CONCLUSION: Males, the elderly, and people living in LMICs need to be particularly concerned about the threat of HCKD attributed to high and low temperatures.