Why there is an alarming increase in kidney disease


This article is part of the “Innovations in: Kidney disease,” an editorially independent special report that was produced with financial support from Vertex.

TThe global burden of chronic kidney disease (CKD) is high and increasing. In 2023, it was the ninth leading cause of death for adults and the 12th leading cause of healthy years lost to disease, disability or premature death. In the United States, researchers estimate that more than one in seven adults has CKD. Nine out of 10 of these people don’t realize they have it, but their kidneys will struggle to filter waste and extra water from the blood as they deteriorate.

CKD has many different triggers and is intertwined with a number of other diseases, including cardiovascular disease and hypertension. An analysis published in 2025 showed that CKD is more common in regions with high diabetes prevalence, such as Oceania and the Middle East. In other areas with high rates, the cause is attributed to genetic variants within regional populations, such as in West Africa and Central America. Variation across communities underscores the complex nature of this noncommunicable disease.


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COUNTRIES FIGHTING KIDNEY DISEASE

In 1990, an estimated 378 million people aged 20 years and older were living with chronic kidney disease (CKD). By 2023, the figure had increased to 788 million worldwide.

The total number of people over 20 with CKD in the United States, standardized for age, has increased by 5 percent since 1990, reaching 11.7 percent in 2023. The global average in 2023 was even higher, at 14.2 percent. Countries with large populations, such as China, have high numbers of cases, but often their rates are actually below the world average. Countries with the highest rates in 2023 are marked.

Bubble chart shows the number of people over 20 with CKD over time. The countries with the highest rate in 2023 were Iran (22.7%), Haiti (22.1%) and Panama (20.9%).

Part of this increase can be attributed to a population that is increasing in both numbers and age. But CKD’s upward trend exceeds that of several other leading causes of death.

Table shows the most important causes of death (standardized for 20 years and over) in 1990 and 2023. Chronic disease went from 14th place in 1990 to 9th place in 2023.

Jen Christiansen; Source: “Global, Regional, and National Burden of Chronic Kidney Disease in Adults, 1990–2023, and Its Attributable Risk Factors: A Systematic Analysis for the Global Burden of Disease Study 2023,” by Patrick B. Mark et al., in LancetVol. 406; 22 November 2025 (data)

WHAT IS KIDNEY DISEASE?

Kidney disease is an umbrella term that includes a wide variety of causes, but in all cases the condition interferes with the kidneys’ ability to filter waste and maintain balance in the body. It is classified based on the amount of damage and residual kidney function.

A healthy kidney illustration fades into a diseased kidney illustration, along a continuum of short-term damage to gradual long-term damage in advanced kidney failure.

How is kidney health tracked?

Doctors divide chronic kidney disease (CKD) into five stages depending on how well the kidneys are working, which helps guide care. Because CKD usually develops gradually, stage-specific treatment can reduce damage and keep the kidneys working as well as possible.

Graphic describes the 5 stages of CKD. In early stages, there are often few or no signs of disease. Symptoms usually begin around stage 4 and include nausea, loss of appetite, vomiting, fatigue, sleep problems, decreased mental acuity and shortness of breath. At stage 5, patients are seriously unwell. The kidneys work at less than 15 percent capacity.
The panel describes how kidney function is measured. There are two tests most commonly used to assess kidney function. A blood test called eGFR measures how efficiently the kidneys filter blood. Low eGFR indicates reduced kidney function. A urine test called uACR detects protein, which is an early sign of kidney damage.

What puts your kidneys at risk?

Kidney damage is often triggered by certain medications or another medical condition, such as severe dehydration, blockage of the urinary tract, or infection. Factors that fall within the following three categories can also increase the risk of developing the disease.

Graphic presents three CKD risk factors: chronic disease, genetics and a compromised immune system.

Where can damage occur in the kidneys?

The kidneys are made up of different structures, and damage to any of them can interfere with how waste is filtered from the blood and removed from the body. Here are some examples of where and how the damage can occur.

Graphic shows the anatomy of the kidney, with five areas highlighted; blood vessels, a cyst on the main kidney tissue, nephrons, glomeruli and kidney stones in the ureter.

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