Chronic kidney disease (CKD), sometimes referred to as a hidden epidemic because it goes undetected in its early stages, is now the ninth greatest cause of death globally, taking more lives every year and placing an increasing cost on public health.

The global analysis, published in The Lancet by researchers with the Institute for Health Metrics and Evaluation (IHME), revealed that the number of adults living with CKD has more than doubled over the past three decades—from about 378 million in 1990 to nearly 788 million in 2023.

The rise is largely driven by ageing populations, unhealthy diets, obesity, diabetes, and high blood pressure — all common in both developed and developing nations.

Researchers found that reduced kidney function was responsible for nearly one in eight cardiovascular deaths.

Chronic kidney disease arises when the kidneys gradually lose their ability to filter waste and excess fluid from the blood.

Many people remain misdiagnosed until irreversible damage has been done, which is often when dialysis or a kidney transplant is needed, because the disease has little or no symptoms in its early stages.

The GBD team drew on more than 2,200 data sources, combining national registries, surveys, and published studies.

They also employed advanced statistical modelling to estimate the contribution of kidney dysfunction to deaths from other diseases.

The study estimated that 14 per cent of the world’s adults currently live with some degree of CKD. In 2023 alone, the condition caused 1.5 million deaths, a 6 per cent increase since 1993 after adjusting for population changes.

China and India top the global list, with 152 million and 138 million adults affected, respectively. But the burden extends far beyond Asia.

The United States, Indonesia, Japan, Brazil, Mexico, Nigeria, and several other countries each report more than 10 million cases. In total, CKD affects about 14 per cent of adults aged 20 and older worldwide.

Regional differences are stark. The highest prevalence was found in North Africa and the Middle East (18.0 per cent), followed by South Asia (15.8 per cent) and sub-Saharan Africa (15.6 per cent). Some of the most affected nations include Iran, Haiti, Nigeria, Panama, and Mexico.

Director of the Centre for Optimal Ageing at NYU Langone, Dr Josef Coresh, in a remark, said chronic kidney disease is common, devastating, and largely under-recognized as a major health threat.

"Our findings show an urgent need for early detection and stronger preventive care,” he said.

Beyond the statistics lies a story of stark inequity. Access to kidney replacement therapies, including dialysis and transplantation, remains limited and uneven across much of the world.

In high-income nations, such treatments are routine. In low- and middle-income countries, they are often out of reach. (Nigerian Tribune)