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

Author:

He Guohua1ORCID,Liu Yunfei23,Bagga Arvind4,Onubogu Chinyere Ukamaka56,Schaefer Franz7,Zou Zhiyong23,Smoyer William E8,Xiao Nianzhou9,Lin Tianxin1011ORCID,Lanewala Ali Asghar12,Kang Hee Gyung13,Waheed Muhammad Zeeshan14,Park Seungkyo15,Jiang Xiaoyun1,Song Yi23,Ding Jie16

Affiliation:

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, Peking University , 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

Abstract

ABSTRACT Background Although congenital abnormalities of the kidney and urinary tract (CAKUT) is the leading cause of childhood-onset chronic kidney disease 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), and calculated the slope index of inequality, the relative index of inequality and concentration index. Results In 2019, the global prevalence, mortality and DALYs of CAKUT among individuals aged 0–24 years were 167.11 (95% confidence interval 166.97, 167.25), 0.30 (0.29, 0.30) and 32.22 (32.16, 32.29), respectively, per 100 000 population. The greatest prevalence, mortality and DALYs were recorded in the 0–4 years 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 and 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.

Funder

National Natural Science Foundation of China

Natural Science Foundation of Beijing

National Key Research and Development Program of China

Publisher

Oxford University Press (OUP)

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