1.
GLOBAL BURDEN OF CHRONIC
KIDNEY DISEASE (CKD)
Presented by:
Mr. RAHUL RANJAN
Nursing Tutor, Dept. of MSN
NNC, Jamuhar, Bihar

2.
CKD
• Chronic kidney disease (CKD) is a condition characterized
by a gradual loss of kidney function over time.
• CKD is defined as kidney damage for months and/or
glomerular filtration rate (GFR) ,60 mL/min per 1.73 m2 for
months with or without kidney damage.

3.
GLOBAL RISKS
• Globally, almost 800 million people lack access to safe
water and 2.5 billion lack access to optimal sanitation.
• In low- and middle-income countries, waterborne and
pestilent diseases associated with poor hygiene and
sanitation are major causes of acute kidney injury and
chronic kidney disease.
• Rapidly occurring urbanization has contributed to the rise of
kidney disease.

4.
Cont..
• Lifestyle changes, e.g. high-calorie, sodium-rich diets and
decreased physical activity, environmental pollution, a limited
infrastructure and poor levels of sanitation and waste disposal.
• A growing prevalence of non-communicable diseases, e.g.
diabetes, hypertension and obesity.
• Increasing rates of obesity, diabetes, and hypertension suggest
that the expected numbers of patients with CKD will rise.

5.
Cont..
• In high-income countries, lower socioeconomic status is
associated with greater risk of end-stage kidney disease
because of behavioral and metabolic risk factors and
reduced access to care.
• In low- and middle-income countries, the burden posed by
poverty-related kidney disease is even greater, because of
associated infections, hazardous work, poor education and
poor maternal health.

6.
GLOBAL BURDEN
• Chronic kidney disease is a worldwide public health problem,
a social calamity and an economic catastrophe.
• Kidney disease is a global public health problem that affects
more than 750 million persons worldwide.
• These patients will eventually need a form of renal
replacement therapy.

7.
Cont..
• The global estimated prevalence of CKD is 13.4%.
• CKD was the 12th leading cause of death globally in 2017, up from
17th in 1990.
• Nearly one-third of those patients lived in two countries – China,
with about 132 million cases, and India, with about 115 million.
• Further, 10 other nations – the US, Indonesia, Russia, Japan,
Brazil, Pakistan, Mexico, Nigeria, Bangladesh, and Vietnam – each
had more than 10 million cases in 2017.

8.
Cont..
• Patients with chronic kidney disease (CKD) have high rates
of healthcare utilization, morbidity, and mortality.
• In 2015, 1.2 million people died from kidney failure, an
increase of 32% since 2005. estimated 5–10 million people
die annually from kidney diseases.
• Male patients had slightly higher mortality rates (52.6/1,000)
than females (43.4/1,000).

9.
Cont..
• Kidney disease is associated with a tremendous economic burden.
• High-income countries typically spend more than 2–3% of their
annual health-care budget on the treatment of end-stage kidney
disease.
• In 2010, 2.62 million people received dialysis worldwide and the
need for dialysis was projected to double by 2030. (WHO, 2018)
• Within low- and middle-income countries, access to dialysis is highly
inequitable

10.
Cont..
• Worldwide, it is shown that around 69,400 kidney transplants
(46% from living donors) performed every year
• Between 1971 and 2015, a total of 21,395 kidneys were
transplanted in India.
• There are around 170 government recognized transplant
centers in India, performing around 3500 transplants annually.

11.
Cont..
• Hemodialysis, peritoneal dialysis, and kidney transplantation save
lives but with great costs, which are becoming a major issue in
western countries because they account for a significant proportion
of healthcare expenditure.
• The burden of kidney disease varies substantially across the world,
as does its detection and treatment.
• Managing the economic and clinical burden of CKD will be a
significant challenge for the healthcare system.

12.
EPIDEMIOLOGY
• Chronic kidney disease (CKD) is increasing worldwide at an annual
growth rate of 8%.
• Regional differences exist in the epidemiology of the condition, and
non-Whites are more affected. (Alebiosu et al. 2005)
• The prevalence of CKD is higher in developing countries than in
the developed world.
• Data on CKD burden have grown dramatically over the past years.

13.
Cont..
• Among high-income countries, Saudi Arabia and Belgium have
the highest estimated CKD prevalence (24%), followed by Poland
(18%), Germany (17%) and the UK and Singapore (16%).
• Over 2 million people worldwide currently receive treatment with
dialysis or a kidney transplant to stay alive, yet this number may
only represent 10% of people who actually need treatment to live.

14.
In India
• The reported prevalence of CKD in different regions ranges from
<1% to 13%, and recently, reported a prevalence of 17%
(International Society of Nephrology's Kidney Disease)
• It is currently one of the most commonly occurring non-
communicable diseases in India.
• Recent studies have also shown that even rising air pollution is a
factor in increasing risk of Chronic Kidney Diseases (CKD).

15.
Cont..
• In several Indian population-based studies in the past estimated that
some 150-230 persons suffer from End-Stage Kidney Disease
(ESKD) in every million people.
• About 2,20,000-2,75,000 new patients need Renal Replacement
Therapy (RRT) every year.
• With increasing incidence of CKD, the number of patients
undergoing dialysis in India is also increasing by 10-15% every year.

16.
Conclusion
• We need universal health coverage to tackle kidney disease
successfully and ensure effective screening, prevention and
early treatment.
• A comprehensive health education campaign and screening
of the general populace are needed in order to detect
chronic kidney disease early.

17.
Thank You!