Disease burden analysis and trend prediction of chronic kidney disease attributable to metabolic factors in China: from 1990 to 2021_Chinese Journal of Evidence-Based Medicine

Authors：

PENG Xinping ,  WANG Yaoguang , ZHAO Xi , WANG Yuhan , WANG Yixiao , LI Jiting , ZHAO Chengshang , ZHANG Wanyu

Tianjin University of Traditional Chinese Medicine First Affiliated Hospital, National Clinical Research Center for Acupuncture, Tianjin 300381, P. R. China;

Corresponding author：

WANG Yaoguang, Email: wangyaoguang1012@126.com

Keywords：

Chronic kidney disease; Metabolic factors; Disease burden; China

DOI：

10.7507/1672-2531.202409153

Video：

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Objective To analyze the trend of chronic kidney disease (CKD) disease burden attributable to metabolic factors in China from 1990 to 2021, and to predict the death of CKD due to metabolic factors in China from 2022 to 2046. Methods Based on the 2021 Global Burden of Disease Database, this paper collected and sorted out the CKD deaths, disability-adjusted life years (DALYs), premature death lost life years (YLLs), and disability life lost years (YLDs) attributed to metabolic factors by different ages and sexes in China from 1990 to 2021, and used the Joinpoint regression model to systematically evaluate the temporal trends of standardized mortality and standardized DALYs rate. The age-period-cohort (APC) model was used to assess age, period, and cohort effects, and the R software Nordpred package was used to predict future changes in the burden of disease. Results Compared with 1990, the mortality rate, DALYs rate, YLLs rate, and YLDs rate attributable to metabolic factors of Chinese residents in 2021 showed an upward trend, and the characteristics of male higher than female, higher age group than lower age group. The primary metabolic factor influencing the disease burden of CKD is hyperglycemia. The results of Joinpoint analysis showed a downward trend in the standardized mortality and standardized DALYs rate of CKD attributed to metabolic factors. The results of age-period-cohort model analysis showed that the age effect of CKD attributed to metabolic factors increased significantly, the period effect increased slowly, and the cohort effect showed a downward trend. Conclusion The disease burden of CKD attributed to metabolic factors in China is generally on the rise, and men, the elderly, and diabetic patients are the key focus of the disease.

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24.	Aires Neto P, Gomes HV, Campos M. Management of hyperglycemia in patients with chronic kidney disease. J Nephrol, 2013, 26(4): 629-635.
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26.	Jiang Z, Wang Y, Zhao X, et al. Obesity and chronic kidney disease. Am J Physiol Endocrinol Metab, 2023, 324(1): E24-E41.
27.	于文娟, 赵蓓, 钟海珍, 等. 老年原发性高血压合并慢性肾病患者的危险因素分析. 中华高血压杂志, 2018, 26(3): 300.
28.	Tuttle KR, McGill JB. Evidence-based treatment of hyperglycaemia with incretin therapies in patients with type 2 diabetes and advanced chronic kidney disease. Diabetes Obes Metab, 2020, 22(7): 1014-1023.

1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int, 2024, 105(4S): S117-S314.
2. Levey AS, Coresh J. Chronic kidney disease. Lancet, 2012, 379(9811): 165-180.
3. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet, 2020, 395(10225): 709-733.
4. Li Y, Ning Y, Shen B, et al. Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019: an analysis of the global burden of disease study 2019. Clin Kidney J, 2022, 16(2): 312-321.
5. Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance. JAMA Intern Med, 2023, 183(4): 298-310.
6. Bowe B, Xie Y, Li T, et al. Changes in the US burden of chronic kidney disease from 2002 to 2016: an analysis of the global burden of disease study. JAMA Netw Open, 2018, 1(7): e184412.
7. 柯倩, 宇传华, 刘晓雪, 等. 基于GBD数据的中国慢性肾病疾病负担现状及趋势分析. 公共卫生与预防医学, 2021, 32(5): 1-5.
8. GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021. Lancet, 2024, 403(10440): 2162-2203.
9. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021. Lancet, 2024, 403(10440): 1951.
10. 刘珊山, 何昱静, 李初谊, 等. 1990―2019年中国归因于饮酒的肝癌疾病负担变化趋势分析. 中国循证医学杂志, 2024, 24(7): 776-782.
11. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med, 2000, 19(3): 335-351.
12. Yang Y, Fu WJ, Land KC. A methodological comparison of age-period-cohort models: the intrinsic estimator and conventional generalized linear models. Sociol Methodol, 2004, 34(1): 75-110.
13. Xu D, Hu J, Wang S, et al. Trends in the prevalence of hypertensive heart disease in China From 1990 to 2019: a joinpoint and age-period-cohort analysis. Front Public Health, 2022, 10: 833345.
14. Arnold M, Park JY, Camargo MC, et al. Is gastric cancer becoming a rare disease. A global assessment of predicted incidence trends to 2035. Gut, 2020, 69(5): 823-829.
15. Ricardo AC, Yang W, Sha D, et al. Sex-related disparities in CKD progression. J Am Soc Nephrol, 2019, 30(1): 137-146.
16. 张珏, 刘芳. 性别与慢性肾脏病. 华西医学, 2021, 36(3): 396-400.
17. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011), 2022, 12(1): 7-11.
18. Ortiz A, Mattace-Raso F, Soler MJ, et al. Ageing meets kidney disease. Clin Kidney J, 2022, 15(10): 1793-1796.
19. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-266.
20. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant, 2009, (9 Suppl 3): S1-S155.
21. Uhlig K, Berns JS, Kestenbaum B, et al. KDOQI US commentary on the 2009 KDIGO clinical practice guideline for the diagnosis, evaluation, and treatment of CKD-mineral and bone disorder (CKD-MBD). Am J Kidney Dis, 2010, 55(5): 773-799.
22. Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med, 2013, 158(11): 825-830.
23. 马越, 孔祥婕, 彭雯, 等. 中国糖尿病疾病负担现状及趋势. 中国预防医学杂志, 2023, 24(4): 281-286.
24. Aires Neto P, Gomes HV, Campos M. Management of hyperglycemia in patients with chronic kidney disease. J Nephrol, 2013, 26(4): 629-635.
25. 王琦, 杜文雯, 宋晓昀, 等. 中国成人体质指数轨迹与高血压及血压水平关系. 卫生研究, 2023, 52(3): 354-361.
26. Jiang Z, Wang Y, Zhao X, et al. Obesity and chronic kidney disease. Am J Physiol Endocrinol Metab, 2023, 324(1): E24-E41.
27. 于文娟, 赵蓓, 钟海珍, 等. 老年原发性高血压合并慢性肾病患者的危险因素分析. 中华高血压杂志, 2018, 26(3): 300.
28. Tuttle KR, McGill JB. Evidence-based treatment of hyperglycaemia with incretin therapies in patients with type 2 diabetes and advanced chronic kidney disease. Diabetes Obes Metab, 2020, 22(7): 1014-1023.

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