ORIGINAL RESEARCH article
Front. Nephrol.
Sec. Clinical Research in Nephrology
Volume 5 - 2025 | doi: 10.3389/fneph.2025.1656865
This article is part of the Research TopicChallenges and Innovations in Healthcare Management and Long-Term Care for an Aging SocietyView all 28 articles
Global burden, regional disparities, and future projections of hypertensive kidney disease in older adults: Analysis of GBD 1990–2021 data
Provisionally accepted
- 1Shanxi Traditional Chinese Medical Hospital, Taiyuan, China
- 2Chinese Academy of Agricultural Sciences Institute of Plant Protection, Beijing, China
- 3Beijing Pineal Diagnostics, Beijing, China
- 4China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Aims Hypertensive kidney disease (HKD) contributes significantly to global morbidity and mortality. This study evaluated the burden of HKD in older adults (≥60 years) across 204 countries from 1990 to 2021 and projected trends to 2045. Methods Data from the Global Burden of Disease Study 2021 were used to estimate HKD prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Age-standardized rates (ASRs) were calculated with 95% uncertainty intervals (UIs). Temporal trends were analyzed using Joinpoint regression. Slope and concentration indices quantified health inequality. Decomposition and frontier analyses explored burden drivers. Future projections were made using Nordpred-based Bayesian age-period-cohort models. Sensitivity analyses assessed model robustness. Risk-attributable mortality was also estimated. Results In 2021, global ASRs were 1674.9 (prevalence), 93.4 (incidence), 36.5 (mortality), and 631.1 (DALYs) per 100,000 older adults. High-SDI regions had higher prevalence (ASPR: 1857.8) and incidence (ASIR: 126.5), while low-SDI regions showed higher mortality (ASMR: 58.6) and DALY rates (ASDR: 972.7). Males across all age groups had higher prevalence (e.g. 95 plus: 9109.6 vs. 7031.5 per 100,000). Leading risk factors included low fruit intake (6.98 deaths per 100,000), high sodium, and lead exposure. From 1990-2021, ASIR (AAPC=0.63%), ASMR (0.99%), and ASDR (0.77%) rose, while ASPR declined (-0.25%). Decomposition attributed burden increases mainly to population growth (72.3%) and aging (6.7%). Frontier analysis revealed substantial room for improvement in middle-SDI countries. Sensitivity analyses confirmed the stability of trend estimates and projections. Forecasts indicate that deaths in adults ≥90 will triple by 2045 (e.g. 95 plus: 75,271 vs. 20,242 in 2021). Conclusion HKD burden has grown substantially, with persistent geographic and socioeconomic disparities. Effective mitigation requires not only demographic-and region-specific interventions but also improved access to early detection and dietary risk reduction. Integration of kidney care into primary health systems and aging-focused strategies will be crucial to curb future disease escalation.
Keywords: hypertensive kidney disease, Global Burden of Disease (GBD), health inequalities, Joinpoint regression, risk factor, prediction
Received: 23 Jul 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Li, Jiao, Cheng, Liu, Kang, Cai, Zhang and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoming Xue, 18534985719@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.