Top 50 cited articles on the treatment of chronic kidney disease: a bibliometric analysis

Abstract Introduction: As the seventh greatest cause of premature mortality, chronic kidney disease (CKD) affects over 850 million people worldwide and poses a public health concern. Despite extensive research on CKD, it is still unclear which studies have had the greatest impact on treatment practices. Bibliometric analysis provides an evidence-based approach to identify key research trends, priorities, and global disparities. This study aimed to determine the 50 most referenced publications on CKD treatment, examining citation patterns, thematic clusters, evidence quality, and global research distribution. Methods: A comprehensive search of the Web of Science Core Collection was performed using the terms “Chronic Kidney Disease” AND “Treatment.” English-language publications involving human CKD treatment were included. After screening in Rayyan, data were extracted on study type, evidence level, treatment modality, and authorship. Analysis proceeded through four steps: (1) data cleaning and standardization; (2) descriptive bibliometrics of publication trends, core journals, and productivity indicators; (3) citation analysis using h-index–type metrics excluding self-citations; and (4) science mapping via VOSviewer and Bibliometrix to visualize keyword co-occurrence networks. Descriptive statistics summarized study characteristics. Results: Randomized controlled trials accounted for only 16% of the top 50 papers (2000–2022), while narrative reviews comprised 42% and review articles 16%. Key subjects included SGLT2 inhibitors, metabolic therapies, and renin-angiotensin-aldosterone system blockade. Research output was concentrated in high-income regions, with limited contribution from low- and middle-income countries. Only 24% of publications achieved Level 1 evidence. Conclusion: The literature on CKD treatment is geographically imbalanced, centralized, and dominated by narrative evidence. Region-specific bibliometric evaluations and more rigorous multicenter trials are required. For Saudi Arabia, aligning locally generated data with international knowledge is essential to develop equitable, context-driven, and evidence-based CKD management strategies.