Global, Regional, and National Burden of CKD in Children and Adolescents from 1990 to 2019

Background: CKD is one of the most prevalent noncommunicable health concerns in children and adolescents around the globe, but data on the prevalence and trends of these diseases are limited. We aimed to assess global, regional, and national trends in the burden of CKD in children and adolescents.Methods: In this trend analysis based on the 2019 Global Diseases, Injuries, and Risk Factors Study, CKD incidence and disability-adjusted life years (DALYs) rates per 100,000 population for children and adolescents are reported at the global, regional, and national levels, as well as average annual percentage change (AAPC). These global trends are analyzed by age, gender, region, and socio-demographic index (SDI).Findings: Globally, the overall incidence of CKD in children and adolescents showed an increasing trend (AAPC 0.44 [95% UI 0.36 to 0.52]) between 1990 and 2019. However, the DALYs of CKD showed a continuous decreasing trend (AAPC -1.18[-1.37 to -0.99]). The population aged 15-19 years old had the largest increase in the incidence of CKD during this period. The largest increase in age-standardized incidence rate (ASIR) was in the country of middle SDI (AAPC 0.56 [0.45 to 0.67]). The relationship between ASIR and SDI showed an inverse U-shaped curve, and the relationship between age-standardized DALYs rate (ASDR) showed an inverse trend with SDI. Among adolescents (15 - 19 years old), ASIR continues to increase for five subtypes of CKD, most notably CKD due to type 2 diabetes mellitus and hypertension. Most of the disease burden was concentrated in countries with lower SDI. Andean Latin America and Central Latin America had the largest increases in CKD ASIR between 1990 and 2019. High-income North America had the largest decrease in ASIR for CKD.Interpretation: The disease burden of CKD in children and adolescents has increased worldwide, especially in regions and countries with lower SDI.Funding: This work was supported by grants from the Natural Science Foundation of the Anhui Province (number 2008085MH244).Declaration of Interest: The authors declare no conflict of interest.