Trends and socioeconomic inequality of the burden of congenital abnormalities of the kidney and urinary tract among children and adolescents

Guohua He; Yunfei Liu; Arvind Bagga; Chinyere Ukamaka Onubogu; Franz Schaefer; Zhiyong Zou; William E Smoyer; Nianzhou Xiao; Tianxin Lin; Ali Asghar Lanewala; Hee Gyung Kang; Muhammad Zeeshan Waheed; Seungkyo Park; Xiaoyun Jiang; Yi Song; Jie Ding

doi:10.1093/ndt/gfae115

Trends and socioeconomic inequality of the burden of congenital abnormalities of the kidney and urinary tract among children and adolescents

Nephrol Dial Transplant. 2024 May 23:gfae115. doi: 10.1093/ndt/gfae115. Online ahead of print.

Authors

Guohua He¹, Yunfei Liu^{2

3}, Arvind Bagga⁴, Chinyere Ukamaka Onubogu^{5

6}, Franz Schaefer⁷, Zhiyong Zou^{2

3}, William E Smoyer⁸, Nianzhou Xiao⁹, Tianxin Lin^{10

11}, Ali Asghar Lanewala¹², Hee Gyung Kang¹³, Muhammad Zeeshan Waheed¹⁴, Seungkyo Park¹⁵, Xiaoyun Jiang¹, Yi Song^{2

3}, Jie Ding¹⁶

Affiliations

¹ Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
³ National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
⁴ Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
⁵ Pediatrics Department, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
⁶ Pediatrics Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
⁷ Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany.
⁸ Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
⁹ Department of Nephrology, Valley Children's Healthcare, Madera, CA, USA.
¹⁰ Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
¹¹ Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
¹² Department of Pediatric Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
¹³ Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
¹⁴ Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China.
¹⁵ Division of Integrated Medicine, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea.
¹⁶ Department of Pediatrics, Peking University First Hospital, Beijing, China.

PMID: 38782719
DOI: 10.1093/ndt/gfae115

Abstract

Background: Although congenital abnormalities of the kidney and urinary tract (CAKUT) is the leading cause of childhood onset chronic kidney disease (CKD) and kidney failure, comprehensive information on the disease burden among children and adolescents globally is lacking. We aim to report the trends and socioeconomic inequality of CAKUT burden for people aged 0-24 years from 1990 to 2019·.

Methods: We reported the prevalence, mortality and disability-adjusted life-years (DALYs) for CAKUT based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, quantified the association of disease burden and socio-demographic index (SDI), calculated the slope index of inequality (SII) the relative index of inequality (RII) and concentration index.

Results: In 2019, the global prevalence, mortality, and DALYs of CAKUT among individuals aged 0-24 years were 167.11 (95%Confident Interval 166.97, 167.25), 0.30 (0.29, 0.30), and 32.22 (32.16, 32.29) per 100 000 population. The greatest prevalence, mortality and DALYs were recorded in the 0-4 year age group. The greatest mortality and DALYs were recorded in low SDI countries and territories. During 1990 to 2019, the prevalence, mortality and DALYs decreased globally, while in low and low-middle countries and territories the reduction was much less slower. India, Nigeria and Pakistan had the highest DALYs. Saudi Arabia and China exhibited a markedly decrease of CAKUT burden. Globally for every 0.1 increase in SDI, there was a 20.53% reduction in mortality, a 16.31% decrease in DALYs, but a 0.38% rise in prevalence.

Conclusions: Inequality for disease burden of varying SDI was increasing globally. Thus, specific preventive and health service measures are needed to reduce the global burden from CAKUT.

Keywords: congenital abnormalities of the kidney and urinary tract (CAKUT); disease burden; inequality.