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Prevalence of chronic kidney disease in Asia: a systematic review and analysis

Liyanage T 1 , Toyama T 2 , Hockham C 3 , Ninomiya T 4 , Perkovic V 1 , Woodward M 1 Show all authors , Fukagawa M 5 , Matsushita K 6 , Praditpornsilpa K 7 , Hooi LS 8 , Iseki K 9 , Lin MY 10 , Stirnadel-Farrant HA 11 , Jha V 12 , Jun M 13

Affiliations 

  • 1 The George Institute for Global Health, Newtown, New South Wales, Australia
  • 2 Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan
  • 3 The George Institute for Global Health, Imperial College London, London, UK
  • 4 Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
  • 5 Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, Japan, Japan
  • 6 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  • 7 Division of Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 8 Hospital Sultanah Aminah, Johor Bahru, Malaysia
  • 9 Okinawa Heart and Renal Association (OHRA) and Clinical Research Support Center, Tomishiro Central Hospital, Okinawa, Japan
  • 10 Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  • 11 GlaxoSmithKline, Value Evidence Outcomes - Epidemiology, Stevenage, Hertfordshire, UK
  • 12 The George Institute for Global Health, India, New Dehli, India
  • 13 The George Institute for Global Health, Newtown, New South Wales, Australia mjun@georgeinstitute.org.au
BMJ Glob Health, 2022 Jan;7(1).
PMID: 35078812 DOI: 10.1136/bmjgh-2021-007525

Abstract

INTRODUCTION: The burden of chronic kidney disease (CKD) is growing rapidly around the world. However, there is limited information on the overall regional prevalence of CKD, as well as the variations in national prevalence within Asia. We aimed to consolidate available data and quantify estimates of the CKD burden in this region.

METHODS: We systematically searched MEDLINE, Embase and Google Scholar for observational studies and contacted national experts to estimate CKD prevalence in countries of Asia (Eastern, Southern and South Eastern Asia). CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or the presence of proteinuria. For countries without reported data, we estimated CKD prevalence using agglomerative average-linkage hierarchical clustering, based on country-level risk factors and random effects meta-analysis within clusters. Published CKD prevalence data were obtained for 16 countries (of the 26 countries in the region) and estimates were made for 10 countries.

RESULTS: There was substantial variation in overall and advanced (eGFR <30 mL/min/1.73 m2) CKD prevalence (range: 7.0%-34.3% and 0.1%-17.0%, respectively). Up to an estimated 434.3 million (95% CI 350.2 to 519.7) adults have CKD in Asia, including up to 65.6 million (95% CI 42.2 to 94.9) who have advanced CKD. The greatest number of adults living with CKD were in China (up to 159.8 million, 95% CI 146.6 to 174.1) and India (up to 140.2 million, 95% CI 110.7 to 169.7), collectively having 69.1% of the total number of adults with CKD in the region.

CONCLUSION: The large number of people with CKD, and the substantial number with advanced CKD, show the need for urgent collaborative action in Asia to prevent and manage CKD and its complications.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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