Global, Regional, and National Burden of CKD in Children and Adolescents

Abstract Background Chronic kidney disease (CKD) in children and adolescents elevates lifelong cardiovascular and kidney failure risk, yet global epidemiological studies remain limited. Methods Data from the Global Burden of Disease (GBD) 2021 were extracted to analyze the incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs) of CKD in children and adolescents aged 0-19 years. Age-standardized rates (ASRs) and Estimated Annual Percentage Change (EAPC) were calculated. The study further examines differences across regions, age groups, sex, risk factors, and etiologies. Health inequality analysis was performed not only to investigate the distribution of CKD, but also to assess the impact of kidney replacement therapy (KRT, including dialysis and transplantation) accessibility on CKD-related DALYs. The Bayesian Age-Period-Cohort model (BAPC) was applied to predict trends in disease burden from 2022 to 2050. Results In 2021, the global incidence of CKD among individuals aged 0-19 years was estimated at approximately 7.54 million, with an Age-Standardized Incidence Rate (ASIR) of 28.62 [95% Uncertainty Interval (UI): 20.88 to 38.08]. Central Asia had the highest ASIR. The low-middle Socio-Demographic Index (SDI) region experienced the fastest increase in ASIR, with an EAPC of 0.403 [95% Confidence Interval (CI): 0.332 to 0.475]. Incidence rates in adolescents aged 14-19 increased by 44.29%. A strong negative correlation was observed between Socio-demographic Index (SDI) and Age-Standardized Mortality Rate (ASMR) (ρ = -0.822, p < 0.001). The concentration index for DALYs shifted from -0.240 in 1990 to -0.293 in 2021. Areas with higher accessibility to KRT consistently bore a lower burden of CKD. By 2050, the ASIR is projected to decrease to 25.54. Conclusion The rise in the health inequality concentration index underscores the importance of enhancing early CKD screening in low SDI areas. Targeted policies, including health education and early CKD screening, should be prioritized.