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Blood Pressure and Hypertension Studies / Chronic Kidney Disease and Diabetes · Journal article
PLOS One · July 31, 2026
Reinforces what was already believed, rather than introducing something new.
This systematic analysis of GBD 2021 data documents that among people aged 75 years and over, CKD prevalence remained stable (slight decline of 0.06% annually) from 1990–2021, while incidence, mortality, and disability burden increased substantially. The findings reveal a shift from a pattern of high prevalence to one characterized by high incidence, mortality, and disability, with marked heterogeneity by region and sociodemographic development level.
Systematic epidemiological analysis using Global Burden of Disease 2021 database. People aged 75 years and over living in 204 countries and territories globally; approximately 127 million with CKD in 2021. Global: 204 countries and territories.
Approximately 127 million people aged 75 years and over living with CKD globally in 2021 Age-standardized prevalence declined slightly with EAPC = -0.06% (95% UI: -0.09% to -0.03%) between 1990–2021 Incidence rate rose significantly with EAPC = 0.50% (95% UI: 0.47%–0.53%)
Mortality rate increased substantially with EAPC = 1.55% (95% UI: 1.48%–1.61%) DALY rate increased with EAPC = 1.07% (95% UI: 1.02%–1.12%), demonstrating prevalence-mortality trend divergence
This epidemiological map reinforces that CKD in the oldest populations is characterized by rising mortality and disability despite stable prevalence, suggesting that screening and management strategies must prioritize incidence and prognostic severity rather than prevalence alone. The marked heterogeneity by region and development level indicates that public health resource allocation and intervention design should be tailored to local epidemiological patterns rather than applying uniform global strategies.
Large-scale epidemiological analysis of established disease burden using rigorous GBD methodology, confirming and extending known patterns of CKD prevalence and mortality in older adults, but not introducing novel interventions or practice changes.
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Quoted from the source exactly as published.
This epidemiological map reinforces that CKD in the oldest populations is characterized by rising mortality and disability despite stable prevalence, suggesting that screening and management strategies must prioritize incidence and prognostic severity rather than prevalence alone. The marked heterogeneity by region and development level indicates that public health resource allocation and intervention design should be tailored to local epidemiological patterns rather than applying uniform global strategies.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
BACKGROUND: Drawing on data from the Global Burden of Disease (GBD) 2021 study, this research provides the first systematic assessment of the burden and trends of chronic kidney disease (CKD) among the global population aged 75 years and over between 1990 and 2021. Unlike previous studies covering the entire age spectrum, this study focuses on the age group with the highest concentration of disease burden and the greatest health vulnerability, with the aim of revealing the unique epidemiological patterns specific to this population. METHODS: The study methodology involved extracting data on the prevalence, incidence, mortality and disability-adjusted life years (DALYs) for chronic kidney disease (CKD) among people aged 75 years and over in 204 countries and territories from the GBD 2021 database. All reported rates are age-standardized. We calculated estimated annual percentage changes (EAPCs) to analyze trends and examined the association between the disease burden and the Sociodemographic Index (SDI). RESULTS: The study found that in 2021, approximately 127 million people aged 75 years and over worldwide were living with CKD. Between 1990 and 2021, the age-standardized prevalence declined slightly (EAPC = -0.06%; 95% UI: -0.09% - -0.03%), whilst incidence, mortality and DALY rates all rose significantly (EAPCs of 0.50%; 95% UI: 0.47%-0.53%, 1.55%; 95% UI: 1.48%-1.61% and 1.07%; 95% UI: 1.02%-1.12%, respectively), demonstrating the key phenomenon of 'prevalence-mortality trend divergence'. The relationship between the burden of disease and socio-economic development is complex: regions with low SDI bear the heaviest burden of mortality, whilst regions with high SDI have experienced the fastest growth in mortality rates. The study also revealed significant heterogeneity in the burden across age, gender and geographical regions. CONCLUSIONS: The burden of chronic kidney disease (CKD) among the global older adult population is rapidly shifting from a pattern of 'high prevalence' to one characterised by 'high incidence, high mortality and high disability', with the underlying drivers exhibiting fundamental differences across regions at various stages of development. This necessitates that public health strategies move beyond a 'one-size-fits-all' approach and instead develop highly age-specific and contextually tailored interventions. This study provides a detailed map for understanding the epidemiology of CKD in the context of extreme population ageing, and offers crucial evidence for the allocation of resources and the formulation of policies.
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