Comparative analysis of the trends in the global and Chinese burden of chronic kidney disease from 1990 to 2021 and prediction of the incidence and mortality rates in China over the next 30 years

Background This study examines the current status and temporal trends in the disease burden of chronic kidney disease (CKD) in China and worldwide from 1990 to 2021, aiming to inform evidence-based strategies for the prevention and control of CKD.Methods The data were sourced from the GBD 2021 public database, covering the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of chronic kidney disease (CKD) among different genders and age groups in China and globally from 1990 to 2021. The average annual percentage change (AAPC) of CKD prevalence and mortality was estimated using the joinpoint regression model. The temporal trends of CKD burden in China and globally were analyzed using R software, and the future 30-year prevalence and mortality of CKD in China were projected using the ARIMA model in the GlobalBurdenR package.Results In 2021, China reported 118.4 million cases of chronic kidney disease (CKD) and 204,230 CKD-related deaths, while globally there were 673.72 million cases and 1,527,638 deaths. From 1990 to 2021, the age-standardized mortality rate of CKD in China declined significantly from 14.16 to 10.84 per 100,000 population, whereas the global rate increased from 14.85 to 18.50 per 100,000. Over the same period, the estimated average annual percentage change (EAPC) in age-standardized prevalence and mortality rates in China was -0.40% and -0.91%, respectively, compared with -0.02% and 0.73% worldwide. Both global and Chinese CKD burdens exhibit notable disparities by gender and age: women have a higher prevalence than men, but lower mortality. The elderly are the primary high-risk group, particularly individuals aged 50 years and older. After adjusting for changes in population age structure, the age-standardized prevalence and mortality rates of CKD in China have exhibited a gradual downward trend and are increasingly stabilizing.Conclusions The disease burden of chronic kidney disease (CKD) in China and globally remains substantial, with notable disparities across regions, age groups, and genders. Projections indicate that China will continue to experience high CKD prevalence and mortality rates through 2050. To effectively mitigate the CKD burden, the implementation of comprehensive prevention and control strategies is still required.