Chronic kidney disease ninth leading cause of death globally
November 19, 2025
2 min read
Key takeaways:
- The global age-standardized CKD prevalence rate rose by 3.5% in 1990 to 14.2%.
- Kidney dysfunction was the seventh leading risk factor attributed to CVD deaths at 11.5%.
HOUSTON — Rising chronic kidney disease prevalence and morbidity rates in 2023 make CKD the ninth leading cause of death globally, according to data presented at ASN Kidney Week.
Since the most recent global CKD study in 2017, Patrick B. Mark, MB, ChB, PhD, professor of nephrology at the School of Cardiovascular and Metabolic Health at University of Glasgow, and colleagues were interested in understanding how the data would reflect on CKD prevalence and mortality, paving the way for implementing recent developments in CKD therapies.
Data derived from Mark PB, et al. FR-OR093. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
Patrick B. Mark
“Eight years is a reasonably long time in nephrology,” Mark told Healio. “We needed to do this to ascertain global CKD prevalence and morbidity based on changes in knowledge and therapies.”
The researchers used the 2023 Global Burden of Diseases, Injuries, and Risk Factors Study to estimate CKD prevalence, incidence and disability-adjusted life-years and mortality rates for adults aged 20 years or older in more than 200 countries and territories from 1990 to 2023.
“We focused on adults because new therapies are licensed to them and the disease is slightly different in children,” Mark said. “We want to have a clear picture and a clearer message for nephrologists and policymakers.”
Researchers collected data across published literature, vital registration systems, kidney failure treatment registries and household surveys. The researchers also assessed the proportion of CV-related deaths that could be linked to CKD and mortality risk factors from the Chronic Kidney Disease Prognosis Consortium.
Results approximated that 788 million people live with CKD (95% uncertainty interval [UI], 743-843), a substantial increase from 378 million in 1990. The global age-standardized CKD prevalence was 14.2% (95% UI, 13.4%-15.2%), a relative increase of 3.5% (95% UI, 2.7%-4.1%) since 1990.
CKD prevalence was highest in North Africa, the Middle East, South Asia, sub-Saharan Africa and Latin America, and rates of CKD of unknown cause were more prominent in Central America.
“It has been clearly emphasized before: There are wide access disparities in dialysis and transplantation,” Mark said. “Although CKD prevalence was lower in areas with lower numbers of CKD-associated conditions, particularly diabetes, I don’t think we should rest on that.”
There were 1.48 million deaths (95% UI, 1.3-1.65) with CKD as the underlying cause. With an age-standardized death rate of 26.5 (95% UI, 23.1-29.5) deaths per 100,000, CKD is the ninth leading cause of death in adults globally, according to the researchers.
In addition, 11.5% (95% UI, 8.4%-14.5%) of CV deaths were attributable to kidney dysfunction, making it the seventh leading risk factor for deaths due to CVD, ahead of high blood glucose and high BMI.
Furthermore, the global age-standardized CKD disability burden was 769.2 DALYs (95% UI, 691.8-857.4), making it the 12th leading cause of death by DALYs. Fasting plasma glucose (31.9%), high systolic blood pressure (24.5%), BMI (23.5%), diet (17.6%) and nonoptimal temperatures (4.4%) were the leading risk factors for CKD DALYs, according to the researchers.
As CKD prevalence and mortality rise, the “huge burden” of CKD requires targeted interventions and exploration of new therapies to address the issue, Mark said.
“Better data, better awareness and implementation of therapies, like renin-angiotensin system blockade and SGLT2 inhibitors, are a start,” Mark said, “Although screening for CKD is the first step in that, treating CKD starts upstream with better cardiometabolic health and lower sodium diets.”
For more information:
Patrick B. Mark, MB, ChB, PhD, can be reached at [email protected].
Perspective
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The new Global Burden of Disease (GBD) analysis shows that CKD is now firmly in the top 10 causes of death worldwide. About 788 million people are affected and roughly 1.5 million people died from CKD in 2023, making it the ninth leading cause of death globally. Most of this burden is not in dialysis or transplant, but in earlier stages: albuminuria with preserved eGFR and moderately reduced eGFR of 30 mL/min/1.73 m² to 60 mL/min/1.73 m². These stages are usually asymptomatic and undiagnosed, yet they drive much of the excess cardiovascular risk. Reduced kidney function accounts for about 12% of global cardiovascular mortality.
For nephrologists, the message is that CKD is now a common, lethal and modifiable cardiorenal–metabolic disease. We need to treat albuminuria and modest eGFR decline as red flags for both kidney and heart disease and systematically use proven therapies, rather than wait until patients reach kidney failure.
We need to scale up early detection, especially albuminuria testing. The GBD work confirms that most CKD sits in early, silent stages. Making serum creatinine/eGFR and urine albumin–creatinine ratio routine in primary care — particularly for people with diabetes, hypertension or obesity — would uncover large numbers of undiagnosed patients at a stage when progression can still be slowed or prevented.
We also need to increase kidney- and heart-protective therapies. We now have a growing set of treatments that slow CKD progression and cut CV events — SGLT2 inhibitors, non-steroidal MRAs and GLP-1 receptor agonists — in addition to angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers and blood pressure control. Policies should focus on getting these drugs, which are now part of clinical guidelines for diabetes and kidney disease, into clinical care.
Josef Coresh, MD, PhD
Disclosures: Coresh reports being a member of the GBD 2023 Chronic Kidney Disease Collaborators.
Sources/Disclosures
Source:
Mark PB, et al. FR-OR093. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
Reference:
Disclosures:
This study was funded by the Gates Foundation, NIH/NIDDK and Wellcome. Mark reports consulting fees, lecture fees and research support from AstraZeneca, Bayer, Boehringer Ingelheim, Pharmacosmos, Stada UK and Vifor and participating in data monitoring and/or endpoint committees for Boehringer Ingelheim, Novo Nordisk and Vertex. Please see the study for all other authors’ relevant financial disclosures.
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