Abstract
BackgroundChronic kidney disease (CKD) is an important contributor to morbidity and mortality from noncommunicable diseases. We aimed to examine the longitudinal trajectories in risk factors, estimate their impact on CKD burden in China from 1991 to 2011, and project trends in the next 20 years.MethodsWe used data from a cohort of the China Health and Nutrition Survey and applied the comparative risk assessment method to estimate the number of CKD events attributable to all non-optimal levels of each risk factors.ResultsIn 2011, current smoking was the leading individual attributable factor for CKD burden in China responsible for 7.9 (95% confidence interval [CI], 7.5–8.3) million CKD cases with a population-attributable fraction of 8.7% (95% CI, 6.0–11.6), while the rates of smoking have reduced and may have mitigated the increase in CKD. High triglyceride (TG) and high systolic blood pressure (SBP) were the leading metabolic risk factors responsible for 6.8 (95% CI, 6.4–7.1) million and 5.8 (95% CI, 5.5–6.1) million CKD-attributable cases, respectively. Additionally, the number of CKD cases associated with high body mass index (BMI), high diastolic blood pressure (DBP), high plasma glucose, and low high-density lipoprotein cholesterol (HDL-C) was 5.4 (95% CI, 5.1–5.6), 3.9 (95% CI, 3.7–4.1), 3.0 (95% CI, 2.8–3.1) and 2.6 (95% CI, 2.5–2.8) million, respectively.ConclusionCurrent smoking, high TG, and high SBP were the top three risk factors that contributed to CKD burden in China. Increased BMI, DBP, plasma glucose, and decreased HDL-C were also associated with the increase in CKD burden.
Highlights
With the rapid development of social economy and the improvement of living standard, people’s lifestyles are changing
Increasing evidence suggests that lifestyles play important role in the prevention and development of non-communicable diseases, especially diabetes, obesity, metabolic syndrome, cardiovascular diseases, and tumor, all of which are the risk factors for the occurrence and development of chronic kidney disease (CKD)
Current smoking had an estimated population-attributable fraction (PAF) of 8.7% and accounted for 7.9 million Chronic kidney disease (CKD) cases in 2011; high TG with a PAF of 7.4% was responsible for 6.8 million cases; and high systolic blood pressure (SBP) had a PAF of 6.3% and contributed to 5.8 million cases
Summary
With the rapid development of social economy and the improvement of living standard, people’s lifestyles are changing. Increasing evidence suggests that lifestyles play important role in the prevention and development of non-communicable diseases, especially diabetes, obesity, metabolic syndrome, cardiovascular diseases, and tumor, all of which are the risk factors for the occurrence and development of chronic kidney disease (CKD). CKD is an important contributor to cardiovascular events, morbidity, and mortality, and this disease has been a worldwide public health problem. The global all-age mortality rate from CKD increased 41.5% between 1990 and 2017.2 The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) ranks CKD as the 12th leading cause of death out of 133 conditions.[3]. Chronic kidney disease (CKD) is an important contributor to morbidity and mortality from noncommunicable diseases. We aimed to examine the longitudinal trajectories in risk factors, estimate their impact on CKD burden in China from 1991 to 2011, and project trends in the 20 years
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