Observational study finds 14% of adults globally affected by chronic kidney disease — Evidence Review
Published in The Lancet, by researchers from NYU Langone Health, University of Glasgow, Institute for Health Metrics and Evaluation
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Table of Contents
Chronic kidney disease (CKD) now affects 14% of adults worldwide, with nearly 1.5 million deaths in 2023, according to a large, comprehensive global analysis. Related studies generally agree with these findings, showing a rising global burden of CKD and highlighting its growing impact on public health, as detailed by the study organization.
- The new study’s findings of a 14% global prevalence and nearly 1.5 million deaths in 2023 are consistent with previous estimates, which have shown a steady increase in CKD cases and mortality since 1990; this trend is largely driven by population growth, aging, and rising rates of diabetes and hypertension 2 3 4 5 6 12.
- Several related studies confirm that CKD is now among the top causes of mortality worldwide, with the disease’s burden especially high in low- and middle-income countries due to limited access to early diagnosis and treatment 2 4 5 12.
- The association between CKD and increased cardiovascular risk is well documented, with multiple studies identifying impaired kidney function as a significant risk factor for cardiovascular deaths, reinforcing the urgency of early detection and intervention 2 6 9 12.
Study Overview and Key Findings
Chronic kidney disease has emerged as one of the most pressing global health challenges, with its prevalence and mortality climbing steadily over recent decades. This study, led by an international team from NYU Langone Health, the University of Glasgow, and the Institute for Health Metrics and Evaluation (IHME), offers the most comprehensive global estimate of CKD in nearly a decade. It highlights not only the scale of the problem, but also the need for early intervention and equitable access to treatments, especially in low-resource settings where advanced therapies remain scarce.
The study was published in The Lancet, utilizing data from over 2,200 research papers and 133 countries, and was also presented at a major nephrology conference. Its findings have informed recent policy decisions, including the World Health Organization’s formal addition of CKD to its global health agenda.
| Property | Value |
|---|---|
| Study Year | 2025 |
| Organization | NYU Langone Health, University of Glasgow, Institute for Health Metrics and Evaluation |
| Journal Name | The Lancet |
| Authors | Josef Coresh, Morgan Grams, Patrick Mark, Lauryn Stafford, Jennifer Lees, Theo Vos, Liane Ong |
| Population | Adults with chronic kidney disease |
| Sample Size | 2,230 published research papers and national health datasets from 133 countries |
| Methods | Observational Study |
| Outcome | Prevalence and mortality of chronic kidney disease |
| Results | 14% of adults worldwide have chronic kidney disease; 1.5 million deaths in 2023. |
Literature Review: Related Studies
To provide broader context for these findings, we searched the Consensus database containing over 200 million research papers. The following search queries were used to identify relevant literature:
- chronic kidney disease prevalence statistics
- kidney disease mortality rates 2023
- global health impact kidney disease
Below is a summary of key topics and findings from related studies:
| Topic | Key Findings |
|---|---|
| What are the global trends in CKD prevalence and mortality? | - CKD prevalence and mortality have increased globally since 1990, largely due to population growth, aging, and rising rates of diabetes and hypertension 2 3 4 5 6 12. - The global prevalence is consistently estimated between 10-14% of adults, with the majority in early stages 3 5 6. |
| How does CKD contribute to other major health outcomes, such as cardiovascular disease? | - CKD is a significant risk factor for cardiovascular morbidity and mortality, contributing to 11-12% of global cardiovascular deaths 2 6 9 12. - The majority of CKD patients die from cardiovascular complications rather than kidney failure itself 2 9 12. |
| What are the disparities in CKD burden and access to care? | - CKD burden is disproportionately higher in low- and middle-income countries, where access to dialysis and transplantation is limited 4 5 12. - Persistent racial, geographic, and socioeconomic disparities in CKD mortality and outcomes are documented, particularly in the U.S. 10 12. |
| What are the primary risk factors and opportunities for intervention in CKD? | - Diabetes, hypertension, and obesity are the main modifiable risk factors; early detection and management can slow disease progression 1 3 4 5 6 11. - New treatments, including SGLT2 inhibitors and GLP-1-based therapies, show promise in reducing CKD progression 6. |
What are the global trends in CKD prevalence and mortality?
Multiple large-scale analyses have documented a steady increase in CKD prevalence and mortality worldwide over recent decades, a trend mirrored in the latest study’s findings. The global prevalence is now estimated at 10-14% of adults, with the majority in early CKD stages. The absolute number of CKD cases and deaths has nearly doubled since 1990, driven by demographic changes and increased exposure to risk factors.
- Age-standardized prevalence has remained relatively stable, but total cases and deaths have risen due to population growth and aging 2 4 6 12.
- The majority of CKD cases are in early stages (stage 1-3), highlighting opportunities for prevention and early intervention 3 6.
- Mortality rates have increased, making CKD a top-ten cause of death globally 2 5 6 12.
- The trends identified in the current study are supported by previous analyses spanning multiple decades and regions 2 3 4 5 6 12.
How does CKD contribute to other major health outcomes, such as cardiovascular disease?
The link between CKD and cardiovascular disease (CVD) is well established. Impaired kidney function significantly increases the risk of heart attack, stroke, and other cardiovascular outcomes. Recent global studies estimate that 11-12% of CVD deaths are attributable to impaired kidney function, reinforcing the importance of CKD as both a direct and indirect health threat.
- Most CKD patients die from CVD rather than progression to kidney failure 2 9 12.
- CKD is an independent risk factor for cardiovascular events, regardless of traditional risk factors 2 6 9 12.
- Studies stress the need for integrated care models targeting both renal and cardiovascular risk 2 6 9.
- The new study’s findings on CVD deaths align closely with prior global analyses 2 6 9 12.
What are the disparities in CKD burden and access to care?
There are significant inequities in CKD outcomes worldwide. Low- and middle-income countries bear the brunt of CKD burden, with limited access to advanced treatments such as dialysis and transplantation. Even in high-income countries like the United States, racial and geographic disparities persist, particularly among older adults and minority populations.
- The highest CKD mortality and disability rates are seen in regions with the lowest healthcare resources 4 5 12.
- Racial disparities exist in CKD mortality, especially in the United States, with Black Americans experiencing nearly twice the mortality rate of White Americans 10 12.
- Geographic disparities in access to kidney replacement therapy result in poorer outcomes, especially where dialysis and transplantation are unaffordable or unavailable 4 5 12.
- The current study highlights these disparities and the need for equitable healthcare policies 4 5 10 12.
What are the primary risk factors and opportunities for intervention in CKD?
Diabetes, hypertension, and obesity are the predominant risk factors for CKD. Early detection—primarily through urine testing and monitoring of kidney function—enables lifestyle and pharmacological interventions that can slow disease progression and reduce complications. Recent advancements, particularly SGLT2 inhibitors and GLP-1 receptor agonists, have shown efficacy in slowing CKD progression, but their uptake and availability are uneven globally.
- The rising prevalence of diabetes and hypertension explains much of the global increase in CKD 1 2 3 4 5 6 11.
- Early diagnosis and intervention can prevent or delay the need for dialysis or transplantation 3 4 6 11.
- New therapies offer hope but require broader adoption to affect global outcomes 6.
- Increased awareness and screening are needed, as many individuals remain undiagnosed until late stages 1 3 6.
Future Research Questions
Despite advances in understanding CKD’s global burden, important gaps remain. Further research is needed to refine prevention strategies, improve early detection, address disparities, and assess the long-term impact of new therapies. Below are several research questions that could drive the next phase of CKD research.
| Research Question | Relevance |
|---|---|
| What are the most effective strategies for early detection of CKD in low-resource settings? | Early detection is crucial for preventing CKD progression, yet access to screening is limited in many countries. Research is needed to identify scalable, cost-effective approaches 4 5 12. |
| How do novel therapies like SGLT2 inhibitors and GLP-1 agonists impact CKD outcomes across diverse populations? | While recent drugs have shown promise, their real-world effectiveness and accessibility across different global settings remain uncertain 6. |
| What are the drivers of racial and geographic disparities in CKD mortality and how can they be addressed? | Persistent disparities in CKD outcomes highlight the need for targeted research into the social, economic, and healthcare system factors contributing to these gaps 10 12. |
| How can integrated care models improve outcomes for patients with CKD and cardiovascular co-morbidities? | Many CKD patients die from cardiovascular complications. Research into integrated management strategies could reduce mortality and improve quality of life 2 6 9 12. |
| What are the long-term projections for CKD burden given current population trends and risk factor trajectories? | Understanding future trends is essential for resource planning and policy development, especially as the burden of CKD is expected to rise with population aging and increasing rates of diabetes and obesity 4 6 7. |