Abstract
Background: Although it is widely known that hypertension is an important cause of chronic kidney disease (CKD), little detailed quantitative research exists on the burden of CKD due to hypertension.Objective: The objective of the study is to estimate the global disease burden of CKD due to hypertension and to evaluate the association between the socioeconomic factors and country-level disease burden of CKD due to hypertension.Methods: We extracted the disability-adjusted life-year (DALY) numbers, rates, and age-standardized rates of CKD due to hypertension from the Global Burden of Disease Study 2019 database to investigate the time trends of the burden of CKD due to hypertension from 1990 to 2019. Stepwise multiple linear regression analysis was performed to evaluate the correlations between the age-standardized DALY rate and socioeconomic factors and other related factors obtained from open databases.Results: Globally, from 1990 to 2019, DALY numbers caused by CKD due to hypertension increased by 125.2% [95% confidential interval (CI), 124.6 to 125.7%]. The DALY rate increased by 55.7% (55.3 to 56.0%) to 128.8 (110.9 to 149.2) per 100,000 population, while the age-standardized DALYs per 100,000 population increased by 10.9% (10.3 to 11.5%). In general, males and elderly people tended to have a higher disease burden. The distribution disparity in the burden of CKD due to hypertension varies greatly among countries. In the stepwise multiple linear regression model, inequality-adjusted human development index (IHDI) [β = −161.1 (95% CI −238.1 to −84.2), P < 0.001] and number of physicians per 10,000 people [β = −2.91 (95% CI −4.02 to −1.80), P < 0.001] were significantly negatively correlated with age-standardized DALY rate when adjusted for IHDI, health access and quality (HAQ), number of physicians per 10,000 people, and population with at least some secondary education.Conclusion: Improving the average achievements and equality of distribution in health, education, and income, as well as increasing the number of physicians per 10,000 people could help to reduce the burden of CKD due to hypertension. These findings may provide relevant information toward efforts to optimize health policies aimed at reducing the burden of CKD due to hypertension.
Highlights
Chronic kidney disease (CKD) is defined as an abnormality in the kidney structure or function present for >3 months [1], and has been a public health concern worldwide in recent years [1,2,3]
We calculated chronic kidney disease (DALY) as the sum of years lived with disability (YLD) and the years of life lost (YLL) due to premature death caused by CKD due to hypertension expressed by the formula: DALYs = + [14, 15, 21]
The number of DALYs caused by CKD due to hypertension increased by 125.2% [95% confidential interval (CI), 124.6 to 125.7%], rising from 4,424.4 (3,817.9 to 5,211.1) in 1990 to 9,962.4 (8,582.3 to 11,544.1) in 2019 (Figure 1A)
Summary
Chronic kidney disease (CKD) is defined as an abnormality in the kidney structure or function present for >3 months [1], and has been a public health concern worldwide in recent years [1,2,3]. CKD has risen from the 29th leading cause of global disability-adjusted life-years (DALYs) in 1990 for all ages to the 18th in 2019 [5]. Hypertension has been identified as a major driver of CKD [4, 12,13,14,15], and from 1975 to 2015, the number of adults with hypertension increased by 536 million [16]. The burden of hypertension has increased significantly, the global importance of CKD due to hypertension has not been widely recognized, and there have been few quantitative studies on the burden of CKD due to hypertension in the past decades. It is widely known that hypertension is an important cause of chronic kidney disease (CKD), little detailed quantitative research exists on the burden of CKD due to hypertension
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