10 March 2011
Prevalence of disease
About Kidney Diseases
The growing prevalence of diabetes worldwide
There are currently over 240 million people with diabetes
worldwide. This figure is projected to rise to 380 million by 2025,
largely due to population growth, aging, urbanization, unhealthy
eating habits, increased body fat and a sedentary lifestyle. By
2025, the number of people with diabetes is expected to more than
double in South-East Asia, the Eastern Mediterranean and Middle
East, and Africa.
It is projected to rise by nearly 20% in Europe, 50% in North
America, 85% in South and Central America and 75% in the Western
Pacific region. The top five countries with the highest prevalence
of diabetes in order include India, China, the United States,
Russia and Japan. Worldwide more than 50% of people with diabetes
are unaware of their condition and are not treated.*About 40% of
people with diabetes will develop CKD which increases the risk of
cardiovascular and other complications of diabetes.
The same things that increase obesity predispose individuals to diabetes and CKD, i.e. family history, presence of hypertension, and some behaviors such as lack of exercise and unhealthy dietary habits. It is important to identify these risks early to reduce the development of diabetes and CKD, since CKD greatly amplifies the risk of cardiovascular events in the diabetic patient.
Growing prevalence of high blood pressure in populations worldwide
High blood pressure is a major global health problem and is projected to get worse. It is the major cause of CKD worldwide. The world population is getting older, and aging is the most common risk factor for the development of high blood pressure and diabetes as well as CKD. Nearly one billion people worldwide have high blood pressure and that number is expected to increase to 1.56 billion by 2025. The prevalence of high blood pressure is predicted to increase by 24 percent in developed countries and by 80 percent in developing regions such as Africa and Latin America. A recent report noted that 333 million adults in economically developed regions such as North America and Europe had high blood pressure in 2000, with an additional 639 million people in developing countries with this condition*.
Growing prevalence of Kidney disease worldwide as a result
The frequency of CKD continues to increase worldwide as does the prevalence of end-stage renal disease (ESRD). The most common, but not only, causes of CKD are hypertension and diabetes. The presence of CKD is associated with a large increase in cardiovascular (CV) risk. Moreover, CV risk increases proportionally as eGFR falls below 60 ml/min. Lastly, death from CV causes is eight-fold higher in CKD, much higher than death from cancer. Consequently, the identification and reduction of CKD has become a vital public health priority.
The reported prevalence of CKD stages 1-4 in the most recent NHANES (national health and nutrition examination survey) between 1999 and 2006 was 26 million (13%) out of approximately 200 million United States residents aged 20 and older. Of these, 65.3% had CKD stage 3 or 4.
The most recent report of the United States Renal Data System estimates that nearly one-half million patients in the United States were treated for ESRD in the year 2004, and by 2010 this figure is expected to increase by approximately 40%. The elderly are a growing segment of the population and at increased risk for renal disease. Additionally, males and African-Americans with pre-existing hypertension or diabetes and CKD are also at much higher risk for ESRD. These observations have also been confirmed throughout the developed world: Europe, Asia, Australia as well as in developing regions such as China, India and Africa*.
*George L. Bakris and Eberhard Ritz, Hypertension and Kidney Disease, A Marriage that Should Be Prevented, Kidney International 75, 449-452 (13 February 2009)
© Allan J. Collins, CKD and the Public Health Agenda for Chronic Diseases, Figure 12.1 (continued; Volume Two) USRDS 2008 ADR, CDRG presentation, 25 March 2009
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