Record numbers of men and women globally are now estimated to have reduced kidney function, a new study shows. Figures rose from 378 million people with the disease in 1990 to 788 million in 2023 as the world population grew and aged, making it for the first time a top 10 cause of death worldwide.
Led by researchers at NYU Langone Health, the University of Glasgow, and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, the analysis explored the rise of the illness, in which the kidneys gradually lose their ability to filter waste and excess fluid from the blood. Mild cases may have no symptoms while the most severe stages can require dialysis, kidney replacement therapy, or an organ transplant.
The findings revealed that about 14% of adults in the world have chronic kidney disease. Results further showed that about 1.5 million people died from the condition in 2023, an increase of more than 6% since 1993 when accounting for differences in countries’ age demographics over time.
“Our work shows that chronic kidney disease is common, deadly, and getting worse as a major public health issue,” said study co-senior author Josef Coresh, MD, Ph.D., director of NYU Langone’s Optimal Aging Institute. “These findings support efforts to recognize the condition alongside cancer, heart disease, and mental health concerns as a major priority for policymakers around the world.”
This May, the World Health Organization formally added chronic kidney disease to its agenda to reduce early deaths from noncontagious illnesses by one-third before 2030. To combat the epidemic, experts first need an up-to-date understanding of its population trends, says Coresh, who is also the Terry and Mel Karmazin Professor of Population Health at the NYU Grossman School of Medicine.
The new report, published online Nov. 7 in the journal The Lancet, is the most comprehensive estimate of the condition in nearly a decade, according to the authors. It is simultaneously being presented at the American Society of Nephrology’s annual Kidney Week conference.
The investigation was conducted as part of the Global Burden of Disease (GBD) 2023 study, the world’s most comprehensive effort to track health loss across countries and over time. Its findings are widely used to guide policymaking and inform global health research.
For the study, the team analyzed 2,230 published research papers and national health datasets in 133 countries. Besides looking for patterns in diagnoses and mortality, the team examined the toll of disability brought about by chronic kidney disease.
Another major finding was that impaired kidney function, on top of killing people directly, was a key risk factor for heart disease, contributing to about 12% of global cardiovascular mortality. The results showed further that in 2023, the condition was the 12th leading cause of diminished quality of life from disability. The biggest risk factors for kidney disease were found to be high blood sugar, high blood pressure, and high body mass index (a measure of obesity).
Most people with chronic kidney disease in the study were in the early stages of the condition. This is important, says Coresh, because swift treatment with drugs and lifestyle changes can prevent the need for more dramatic and expensive interventions such as dialysis and kidney transplantation.
He adds that in sub-Saharan Africa, Southeast Asia, Latin America, and other low-income regions, relatively few people receive dialysis or kidney transplants—likely because these treatments are less available and harder to afford in those areas.
“Chronic kidney disease is underdiagnosed and undertreated,” said study co-lead author Morgan Grams, MD, Ph.D. “Our report underscores the need for more urine testing to catch it early and the need to ensure that patients can afford and access therapy once they are diagnosed.”
Grams, the Susan and Morris Mark Professor of Medicine at the NYU Grossman School of Medicine, notes that new medications have become available in the past five years that can slow kidney disease progression and reduce the risk of heart attack, stroke, and heart failure. However, it will take time to see improvements on a global scale.
Grams also cautions that since chronic kidney disease is undertested, it may be even more common than the current results suggest.