Key result
Japan shows a ~114% higher incidence of hypertension-attributed CKD compared to China.
Why the study?
To evaluate the burden and temporal trends of chronic kidney disease attributable to hypertension in China, Japan, and the Republic of Korea from 1990 to 2023.
Observational
Absolute Event Rate: 37.43% vs 17.5%
The burden of hypertension-attributed CKD has followed divergent trajectories across East Asia, with Japan experiencing a disproportionately high and recently accelerating incidence.
Alerts clinicians to Japan's disproportionate hypertension-CKD burden; hypothesis-generating for divergent East Asian trajectories requiring prospective validation.
Objective To evaluate the burden and temporal trends of chronic kidney disease (CKD) attributable to hypertension in China, Japan, and the Republic of Korea from 1990 to 2023 using Global Burden of Disease (GBD) 2023 data. Methods Age-standardized incidence, mortality, and DALYs rates (ASIR, ASMR, and ASDR [age-standardized DALYs rate], respectively) and estimated annual percentage change (EAPC) were calculated for the three countries and globally. Segmented regression identified phase-specific inflections in incidence trends, decomposition analysis partitioned absolute changes into population growth, aging, and epidemiological contributions, and age-period-cohort (APC) analysis characterized drivers of ASDR. Attributable fractions ranked modifiable risk factors for cause-specific mortality. Results In 2023, Japan had the highest ASIR (37.43 per 100,000) while China had the lowest (17.50 per 100,000); all three countries fell below the global ASMR and ASDR. China and the Republic of Korea achieved significant declines across all standardized rates, whereas Japan’s near-null overall incidence trend concealed a marked late-period acceleration (2017–2023 APC = 0.86%). Globally, ASMR and ASDR rose significantly. Burden concentrated in adults aged 75–79 years and was consistently higher in males globally. Epidemiological change strongly offset demographic pressures in all three countries, and descriptive APC examination identified protective period- and cohort-related patterns in China and the Republic of Korea but an emerging adverse cohort-related pattern in Japan. High systolic blood pressure dominated attributable mortality (67%–89% in 2023), with the contribution of high body-mass index rising substantially over the study period. Conclusion The burden of hypertension-attributed CKD has followed markedly divergent trajectories across East Asia, with Japan bearing a disproportionately high and recently accelerating incidence, underscoring the need for age-targeted screening and country-specific prevention strategies.
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Hu et al. (2026) conducted an observational in Chronic kidney disease due to hypertension. Geographic location (Japan) vs. China and Republic of Korea was evaluated on Age-standardized incidence rate (ASIR) per 100,000 population in 2023. The burden of hypertension-attributed CKD followed divergent trajectories across East Asia, with Japan bearing a disproportionately high ASIR of 37.43 per 100,000 in 2023 compared to 17.50 in China.
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