Epidemiological research on diabetic nephropathy at global, regional, and national levels from 1990 to 2021: an analysis derived from the global burden of disease 2021 study

Objective: A comprehensive assessment of the disease burden is essential for developing effective strategies to address diabetic nephropathy. This study investigates the long-term global trends and epidemiological characteristics of diabetic nephropathy. Methods: Data on diabetic nephropathy from the Global Burden of Disease (GBD) 2021 were utilized to evaluate morbidity, mortality, disability-adjusted life years (DALYs), and the impact of the Socio-Demographic Index (SDI). Global risk attribution was assessed, and the Bayesian Age-Period-Cohort (BAPC) model was applied to forecast the future burden of diabetic nephropathy. Results: In 2021, there were 107.6 million prevalent cases of diabetic nephropathy globally (95% UI: 99.2-116.0), with an age-standardized prevalence rate of 1,259.6 per 100,000 population (95% UI: 1,162.0-1,359.9), representing a 5.1% decline since 1990. Global deaths attributed to diabetic nephropathy in 2021 reached 477.3 thousand (95% UI: 401.5-566.0), with an age-standardized mortality rate of 5.7 per 100,000 (95% UI: 4.8-6.8), reflecting a 37.8% increase since 1990. The number of DALYs attributable to diabetic nephropathy was 11,278.9 thousand (95% UI: 9,682.8-13,103.9), with an age-standardized DALY rate of 131.1 per 100,000 (95% UI: 112.8-152.5), indicating a 24% rise since 1990. Conclusions: Over the past three decades, the global age-standardized prevalence of diabetic nephropathy has declined, while age-standardized mortality and DALY rates have increased. Significant disparities exist in prevalence, incidence, and DALY rates across regions and countries. The SDI exerts a notable influence on diabetic nephropathy prevalence, underscoring the importance of sustained and enhanced management of risk factors to prevent and treat this condition. Diabetic nephropathy remains a critical global health challenge moving forward.