Measures of the burden of chronic kidney disease (CKD) have risen dramatically in the 21st century—including more than 50% increases in rates of premature death and disability-adjusted life-years due to CKD. Those are among the alarming findings of a new analysis of changes in the health impact of CKD, published in late 2018 in JAMA Network Open (1).
The rising burden of CKD has occurred at a time when the United States has seen declining health burdens overall and from noncommunicable diseases in particular, according to the analysis of national and state-level data.
“Clearly, there needs to be more emphasis on prevention and addressing risk factors, but also on therapies to treat or reverse CKD,” said senior author Ziyad Al-Aly, MD, of the Washington University School of Medicine in St. Louis and Veterans Affairs of St. Louis Health Care System. “Our report should be used to raise awareness of CKD among policymakers—unfortunately, it is often ignored—and CKD should be included in the public health agendas at the county, state, and federal levels. This report should be also used to advocate for more research funding in kidney disease, which in our view should be aligned with the burden of disease.”
The study raises special concerns about the rising impact of CKD in younger Americans. “We expected to see that burden of CKD would rise as the US population aged,” Al-Aly said. “But we were alarmed that the probability of death increased among those in the 20- to 54-year age group and that this increase was mostly driven by death due to diabetic CKD.
“Our findings suggest not only increased burden of CKD among this segment of the population, but that it was driven by increased exposure to metabolic and dietary risk factors and, most alarmingly, this has resulted in increased probability of death due to CKD among this young age group. Metabolic and dietary risks among this age group should be targeted aggressively to reduce burden of CKD.”
Bowe B, et al.. Changes in the US burden of chronic kidney disease from 2002 to 2016: An analysis of the Global Burden of Disease Study. JAMA Netw Open. 2018; 1(7):e184412. doi:10.1001/jamanetworkopen.2018.4412