Global burden of chronic kidney disease in adults aged 60 years and older, 1990-2021 and projections to 2050: an analysis of the global burden of disease study 2021

Background Chronic kidney disease (CKD) represents a significant global public health challenge and is often underestimated in those over 60. Understanding its impact on the elderly individuals is crucial for proper healthcare resource allocation. Methods The Global Burden of Disease Study 1990–2021 data was analysed to assess CKD incidence, prevalence, mortality, and disability-adjusted life years (DALYs) in individuals aged 60 and older. Health disparities were evaluated via the slope index of inequality and the concentration index, whereas frontier analysis was used to predict outcomes on the basis of development levels. Decomposition analysis identified factors affecting disease burden changes, Joinpoint regression was used to analyse temporal trends, and the Bayesian age-period-cohort (BAPC) model was used to project future disease burden trends. Results From 1990 to 2021, the incidence, mortality, and DALY rates of CKD in the global elderly population showed an increasing trend, whereas the prevalence rate exhibited a decreasing trend. The age-standardized incidence rate (ASIR) was highest in high-social development Index (SDI) regions, while the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) were highest in low-SDI regions. In China, the age-standardized prevalence rates (ASPR), ASMR, and ASDR have been on a decline, yet the ASIR has been on the rise. The ASPR and ASIR are slightly higher in women than in men, whereas the ASMR and ASDR are higher in men than in women. By 2050, the global disease burden of CKD among the elderly population is projected to continue increasing, with the trend becoming more pronounced with advancing age. High blood sugar, hypertension, obesity, and low intake of fruits and vegetables are the primary risk factors associated with CKD-related DALYs among elderly individuals. Conclusions In 2021, the global burden of CKD in older adults showed a decline in the ASPR but an increase in the ASIR, ASMR, and ASDR, which are projected to increase over the next 30 years. Key risk factors include high blood sugar, hypertension, obesity, and low fruit and vegetable intake.