Global, SexSpecific, and Socioeconomic Disparities in Chronic Kidney Disease Burden: An AgePeriodCohort Analysis

Introduction. Chronic kidney disease (CKD) is a major global public health challenge, driven by aging, diabetes, hypertension, and socioeconomic disparities. This study analyzed the global CKD burden from 1990 to 2021 by sex and Socio-demographic Index (SDI) to inform targeted interventions.Methods. Using Global Burden of Disease (GBD) 2021 data for 204 countries and territories, we assessed incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Age- standardized rates (ASRs) per 100,000 were based on the GBD World Standard Population. Temporal trends were measured as percentage changes in ASRs (1990–2021) and visualized by SDI quintile and sex. Age–Period–Cohort (APC) modeling with median constraints estimated rate ratios (RRs) and 95% confidence intervals (CIs) using the NCI Webtool.Results. From 1990 to 2021, global age-standardized CKD burden increased substantially. The largest increases attributable to risk factors were for high body mass index (76.59% globally; 107.81% in low-middle SDI), high fasting plasma glucose (46.59% globally; 88.76% in high SDI), and high systolic blood pressure (44.31% in low-middle SDI). Males had higher mortality and DALY rates acrossall SDI levels; females had higher incidence and prevalence. A positive cohort gradient was more evident among males. The 1982 birth cohort RR was 1.14 (95% CI 1.01–1.29) in males and 1.00 (95% CI 0.87–1.14) in females, suggesting rising modeled generational burden among younger adult male cohorts.Conclusion. The global CKD burden has risen markedly, with persistent sex and socioeconomic disparities. Accelerating burden among younger generations requires age- and sex-sensitive prevention, improved healthcare access, and targeted interventions tailored to regional SDI levels.