Quantifying inequalities and forecasting the burden of chronic kidney disease from 1990 to 2040

Chronic kidney disease (CKD) poses a growing global health challenge. Using data from 953 locations, we analyzed spatiotemporal patterns of CKD burden, quantified disparities by inequality and frontier analysis, and developed a deep-learning model to forecast burden to 2040. Marked subnational heterogeneity was observed: a total of 76 locations experienced a doubling of age-standardized mortality rates (ASMR) since 1980, and no country achieved the health frontier level for mortality, incidence, or years of life lost. Accordingly, scenario forecasts indicate that prioritized management of high fasting plasma glucose (FPG) could yield the most substantial reduction globally, potentially lowering ASMR by 47.5% and disability-adjusted life years (DALYs) by 38.9% by 2040. Targeting high body mass index and high systolic blood pressure would also reduce DALYs by 27.6% and 26.6%, respectively, with ASMR reductions by 47.5% and 35.0%. This study provides comprehensive granular evidence on the pervasive and worsening inequalities in CKD.