Burden of chronic kidney disease in China: trends, etiological shifts and key risk factors based on GBD 2023 data

Chronic kidney disease (CKD) represents a growing global public‑health threat, formally listed as a priority non‑communicable disease by the WHO in 2025. Characterized by kidney damage or sustained reduced glomerular filtration, CKD often progresses silently in early‑to‑middle stages. Low public awareness delays diagnosis and treatment, raising risks of cardiovascular complications, end‑stage renal disease, dialysis or kidney transplantation. While previous national surveys reported China’s CKD prevalence, nationwide evidence on incidence, mortality, disability‑adjusted life‑years (DALYs), temporal trends and risk‑factor contributions remained limited. 

Drawing on the Global Burden of Disease (GBD) 2023 dataset, researchers from Peking University systematically analysed national CKD‑related incidence, mortality and DALYs. The team is led by Professor Luxia Zhang from Peking University First Hospital, with Dr.  Jinwei Wang as the first author. Their findings were made available online on June 26, 2026, and published in Chinese Medical Journal in Volume 139, Issue 15 on August 05, 2026. 

In 2023, roughly 156 million Chinese people were estimated to suffer from CKD. Type‑2 diabetes and hypertension stood out as leading etiological contributors. From 1990 to 2023, crude CKD incidence increased at an annual rate of 1.67%, whereas crude DALYs and mortality stayed relatively stable. Once adjusted for age, incidence, DALYs and mortality all demonstrated downward trends, indicating that population ageing largely pushed up the observed crude burden. 

Notable shifts in disease aetiology unfolded across decades. Glomerulonephritis used to dominate CKD‑attributable DALYs and mortality. After 2006, type‑2 diabetes became the top driver, which was later overtaken by hypertension‑related CKD around 2015. Such transformations mirror the rising national prevalence of hypertension and type‑2 diabetes in China. 

Comparing age‑standardized DALY estimates between 2010 and 2023, the top‑five risk factors for CKD were high fasting plasma glucose, high systolic blood pressure, dietary risks, high body‑mass index (BMI) and non‑optimal ambient temperature. Most risk factors achieved marked reductions in their attributable DALY rates. However, the contribution of high BMI remained stable with a slight increase of 4.88%, signalling obesity as an inadequately mitigated risk factor for CKD‑related disability and death. 

Men showed lower CKD incidence and prevalence than women, yet suffered higher DALY and mortality burdens. This gender‑specific disparity deserves clinical attention. 

Professor Zhang’s team has long focused on CKD burden, risk factors and integrated prevention‑control strategies, leveraging big‑health‑data approaches. Their new findings highlight that population ageing impedes further reductions of CKD‑caused disability and death. Hypertension, diabetes and unhealthy lifestyles generate substantial CKD burden, while obesity constitutes an unresolved modifiable threat. 

The research suggests that public‑health interventions targeting metabolic risk factors, especially obesity, should be strengthened alongside strategies coping with population ageing, to ease China’s heavy CKD public‑health load. 

*** 

. 

Reference 
Title of original paper: Incidence, DALYs, and death rates of chronic kidney disease in China, 1990–2023: Results from the Global Burden of Disease Study 2023   
Journal: Chinese Medical Journal  
DOI: 10.1097/CM9.0000000000004162 

About Prof. Luxia Zhang from Peking University First Hospital 
Prof. Luxia Zhang has carried out a series of domestically leading and internationally advanced researches on the disease burden, risk factors and integrated prevention‑control of chronic kidney disease in China. In recent years, she has devoted herself to exploring the application of big health‑care data in the prevention, control and management of major diseases. To date, she has published more than 200 papers in top‑tier international journals including N Engl J Med, The Lancet and BMJ. Her most‑cited single paper has received 1,389 external citations, and she has authored five Chinese monographs. For consecutive years, she has been listed on Stanford University’s World’s Top 2% Scientists and Elsevier’s Most Cited Chinese Researchers. 

Funding information 
This study was supported by grants from the Non-communicable Chronic Diseases-National Science and Technology Major Project (Nos. 2024ZD0524100, 2024ZD0524102 and 2024ZD0524104), the National Natural Science Foundation of China (No. 72125009), CAMS Innovation Fund for Medical Sciences (No. 2019-I2M-5-046), PKUHSC-JUNTENDO Joint Institute for Medical Research (No. BMU2026JIJU009), and National High Level Hospital Clinical Research Funding (Interdepartmental Research Project of Peking University First Hospital: 2024IR14 and State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University: 24QZ007).