Global health inequalities of chronic kidney disease: a meta-analysis

Rachael Duff, Omodolapo Awofala, Muhammad Tahir Arshad, Emilie Lambourg, Peter Gallacher, Neeraj Dhaun, Samira Bell (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
52 Downloads (Pure)

Abstract

Background and hypothesis: Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis.

Methods: Five databases were searched from 2014 to 2022, with 14,871 articles screened, 119 papers included and data analysed on 29,159,948 participants. Random effects meta-analyses were conducted to determine overall prevalence, prevalence of stages 3 – 5 and prevalence in males/females. Influences of age, sex and socio-economic status were assessed in subgroup analyses, and risk of bias assessment and meta-regressions were conducted to explore heterogeneity.

Results: Overall prevalence of CKD was 13.0% (11.3 – 14.8%) and 6.6% (5.6 – 7.8%) for stages 3 – 5. Prevalence was higher in studies of older populations (19.3% for stages 1 – 5, 15.0% for stages 3 – 5) and meta-regression demonstrated association of age, body mass index, diabetes and hypertension with prevalence of stages 3 – 5. The prevalence of CKD stages 1 – 5 was similar in males and females (13.1% versus 13.2%) but prevalence of stages 3 – 5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low, middle and high-income countries respectively; for stages 3 – 5 prevalence was 4.0%, 6.7% and 6.8%, respectively. Included studies were at moderate-high risk of bias in the majority of cases (92%), and heterogeneity was high.

Conclusion: This study provides a comprehensive assessment of CKD prevalence, highlighting important disparities related to age, sex and socio-economic status. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low or middle income countries.
Original languageEnglish
Article numbergfae048
Number of pages49
JournalNephrology Dialysis Transplantation
Early online date22 Feb 2024
DOIs
Publication statusE-pub ahead of print - 22 Feb 2024

Keywords

  • CKD
  • prevalence
  • systematic review
  • global health

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