Disease burden of chronic kidney disease in children aged 0−14 years woeldwide, 1990−2019

Objective To analyze the prevalence and disease burden of chronic kidney disease (CKD) in children aged 0–14 years worldwidw during 1990−2019, and provide evidence for prevention and control of pediatric CKD.

Methods Based on the data of pediatric CKD from the database of Global Burden of Disease Study 2019, we analyzed the morbidity, prevalence, mortality, and disability-adjusted life years (DALYs) of pediatric CKD and their changes in 204 countries and regions with different socio-demographic index (SDI). DALYs consisted of years of life lost (YLL) and years lived with disability (YLD). The average annual percentage change (AAPC) was calculated to evaluate the trend of global CKD burden in children aged 0–14 years from 1990 to 2019.

Results Globally, the morbidity, prevalence, mortality, and DALYs rates of pediatric CKD were 38.11/100 000, 483.6/100 000, 0.86/100 000, and 92.99/100 000, respectively, in 2019. The morbidity and prevalence in girls were 39.72/100 000 and 504.99/100 000 respectively, which were higher than those in boys (36.61/100 000 and 463.55/100 000). The mortality and DALYs rates in boys were 0.9/100 000 and 95.59/100 000 respectively, which were higher than those in girls (0.83/100 000 and 90.22/100 000). The morbidity, mortality, and DALYs rates in age group <1 year were higher than those in other age groups. From 1990 to 2019, the morbidity and prevalence rates of pediatric CKD showed increasing trends (AAPC=0.42%, 95%CI: 0.38%–0.46%; AAPC=0.55%, 95%CI: 0.52%–0.57%), while the mortality and DALYs rates showed decreasing trends (AAPC=−2.02%, 95%CI: −2.21%–−1.84%; AAPC=−1.62%, 95%CI: −1.76%–−1.49%). In addition, the YLL rate showed a downward trend (rate of change =−0.46%, 95%CI: −0.58%–−0.17%), while the YLD rate showed an upward trend (rate of change =0.28%, 95%CI: 0.23%–0.33%). The burden of CKD in children aged 0−4 years was severer in regions with low, low-moderrate and moderate SDI.

Conclusion Pediatric CKD morbidity rate increased while the mortality rate decreased in the world. The overall DALYs declined, but given the increased YLD, the contribution of lower YLL was likely to be greater. Moreover, the disease burden of CKD in children aged 0−4 years varied with age, gender, country, and region.