Chronic Kidney Disease Emerging As A Global Health Crisis: Lancet Study

Chronic kidney disease (CKD) has quietly grown into one of the world’s most pressing public health challenges, affecting nearly 14% of the global adult population and claiming 1.5 million lives in 2023, according to a new analysis published in The Lancet.

The figure marks a 6% rise in deaths since 1993, after adjusting for changes in age demographics, underscoring the growing toll of the largely underdiagnosed condition.

The study — conducted by researchers at NYU Langone Health, the University of Glasgow, and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington — offers the most comprehensive assessment of CKD in nearly a decade. It forms part of the Global Burden of Disease (GBD) 2023 study, the world’s largest and longest-running effort to track health loss across nations and time.

Chronic kidney disease occurs when the kidneys gradually lose their ability to filter waste and excess fluid from the blood. While mild cases often remain symptomless, severe stages can lead to kidney failure requiring dialysis, replacement therapy, or transplantation.

“Our work shows that chronic kidney disease is common, deadly, and worsening as a global public health issue,” said Dr. Josef Coresh, co-senior author of the study and Director of NYU Langone’s Optimal Aging Institute. “The findings support recognising the condition alongside cancer, heart disease, and mental health as a major global policy priority.”

The World Health Organization (WHO), in May this year, formally included CKD in its strategy to reduce premature deaths from non-communicable diseases (NCDs) by one-third before 2030.

Researchers analysed 2,230 studies and national datasets from 133 countries, mapping not only the mortality trends but also the disability burden caused by kidney disease. Their findings reveal that beyond being a cause of death, impaired kidney function significantly contributes to cardiovascular disease, accounting for 12% of global heart-related mortality.

In 2023, CKD ranked as the 12th leading cause of disability-related health loss worldwide. The biggest risk factors identified were high blood sugar, high blood pressure, and obesity.

Most of those living with CKD were found to be in the early stages of the condition — a crucial window for prevention and management. According to Dr. Coresh, timely detection and treatment through lifestyle changes and medication can help delay or prevent the need for dialysis or transplantation.

However, the report warns that in low- and middle-income regions such as sub-Saharan Africa, Southeast Asia, and Latin America, access to dialysis and transplant services remains severely limited due to high costs and inadequate infrastructure.

“Chronic kidney disease is underdiagnosed and undertreated,” said Dr. Morgan Grams, co-lead author of the study and the Susan and Morris Mark Professor of Medicine at NYU Grossman School of Medicine. “Our report underscores the need for widespread urine testing to detect the disease early and ensure affordable access to treatment.”

Dr. Grams noted that the past five years have seen the emergence of novel therapies that can slow CKD progression and reduce risks of heart attack, stroke, and heart failure. However, she cautioned that because CKD remains under tested globally, its true prevalence may be even higher than current estimates suggest.

“Even as treatment options expand, the benefits will take time to be reflected in population-level data,” she said.

The researchers emphasised that addressing the CKD epidemic will require sustained investment in early screening, public awareness, and healthcare infrastructure, particularly in resource-poor settings.

Other co-authors of the study include Dr. Patrick Mark and Dr. Jennifer Lees from the University of Glasgow, and Dr. Theo Vos, Dr. Liane Ong, and Ms. Lauryn Stafford from the Institute for Health Metrics and Evaluation in Seattle.

As the study’s authors conclude, chronic kidney disease — long overshadowed by more visible non-communicable diseases — must now be recognised as a major and growing contributor to global mortality and disability, demanding the same urgency and attention as heart disease and cancer.