A Hidden Epidemic: More than 850 Million Suffer from Kidney Diseases Worldwide, Organizations Report

The global burden of kidney diseases is much higher than commonly reported, according to a notice recently issued by the American Society of Nephrology (ASN), European Renal Association—European Dialysis and Transplant Association (ERA-EDTA), and International Society of Nephrology (ISN).

“We estimate that over 850 million people worldwide have some form of kidney disease, which is roughly double the number of people who live with diabetes (422 million [1]) and 20 times more than the prevalence of cancer worldwide (42 million [2]) or people living with AIDS/HIV (36.7 million [3]),” the groups stated.

The three organizations are collaborating to raise awareness of kidney diseases worldwide and to improve prevention efforts.

“It is high time to put the global spread of kidney diseases into focus,” said Professor David Harris, current president of the ISN and Professor Adeera Levin, Past-President of the ISN.

Although kidney diseases are one of the most common health problems worldwide, many people are unaware of their impaired kidney function, and the public at large is not aware of the extent of this health issue.

Chronic kidney diseases—abnormalities of kidney structure or function that persist for more than 3 months—account for most current prevalence estimates, at 10.4% among men and 11.8% among women (4).

Between 5.3 and 10.5 million people need dialysis or transplantation, yet many do not receive either treatment owing to financial barriers or lack of resources. Acute kidney injury, which may resolve or lead to chronic kidney diseases or kidney failure at a later time, affects 13.3 million people each year.

“Using all these sources of data, and existing estimates of acute and chronic kidney diseases, we estimate approximately 850 million kidney patients . . . a number which surely signifies an ‘epidemic’ worldwide,“ Levin said.

Kidney diseases’ effects on other health outcomes

According to a Global Burden of Disease study that looked at mortality and health outcomes data from 1990 to 2013, people with kidney diseases have a much higher age-standardized mortality rate owing to low kidney function, at 21 deaths per 100,000 people.

Prof. Carmine Zoccali, president of the ERA-EDTA, noted that the cardiovascular death toll from chronic kidney diseases is especially large: In 2013, 1.2 million cardiovascular deaths were attributed to kidney diseases [5].

“The death rate among people with kidney diseases is incredibly high. AIDS, for example, accounts for only 1.9 deaths per 100,000 [6], but think about all the campaigning with celebrities and the resulting recognition of HIV as a priority health issue,” Zocalli said. “There is only little active campaigning on behalf of people with kidney diseases, even though the number of people who die from kidney deterioration is 11 times higher.”

“It is time for constructive change in kidney care policy,” said Mark D. Okusa, MD, FASN, ASN president. “The number of people with kidney diseases is alarmingly high, but the public is not aware of this reality. These patients have outcomes and kidney diseases impose a heavy financial burden on healthcare budgets.“

References

4. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385:117–71.

5. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388:1459–1544.