Burden of chronic kidney disease due to type 2 diabetes mellitus in Asia: A retrospective analysis

Chronic kidney disease (CKD) attributable to type 2 diabetes mellitus represents a substantial contributor to morbidity and mortality across Asia; however, comprehensive evaluations of long-term trends and regional heterogeneity remain limited. This study quantified the burden and temporal trends of CKD due to type 2 diabetes mellitus in Asia using estimates from the Global Burden of Disease (GBD) study. We estimated age-standardized incidence, prevalence, and mortality of CKD due to chronic kidney disease attributable to type 2 diabetes mellitus across Asia and its sub-regions using GBD data, with Asia-level estimates available through 2021 and sub-regional estimates through 2023. We performed Joinpoint regression analysis, with permutation tests (National Cancer Institute Joinpoint version 5.2.0), to imply significant changes in inflection points. Calculations for Annual Percentage Changes (APCs) and average annual percent changes (AAPCs) with 95% confidence intervals were also carried out. In 2021, an estimated 69.15 million individuals (95% UI: 53.73-74.77 million) in Asia were living with CKD attributable to chronic kidney disease attributable to type 2 diabetes mellitus, corresponding to an age-standardized prevalence rate (ASPR) of 1354 per 100,000 population (95% UI: 1248-1464). The age-standardized incidence rate (ASIR) was 20.26 (95% UI: 18.68-21.72) per 100,000, while the age-standardized death rate (ASDR) was 6.04 (95% UI: 5.08-7.21). From 1990 to 2021, ASPR declined modestly (AAPC: -0.28%), whereas ASIR increased (AAPC: 0.52%) and ASDR remained largely stable. Marked regional disparities were observed. Central Asia demonstrated sustained increases in prevalence, incidence, and mortality, including a rising ASDR between 1980 and 2023 (AAPC: 0.81%; 95% CI: 0.21-1.41). East Asia showed increasing prevalence alongside declining incidence and mortality, while Southeast Asia exhibited rising prevalence and incidence with decreasing mortality. Males consistently had higher prevalence, incidence, and mortality than females. The CKD in type 2 diabetics showed much regional variation throughout Asia. Although improvements in incidence and mortality were observed, the persistently high prevalence signifies a rapidly expanding population of diabetic CKD individuals. These findings underscore the urgent necessity for region-specific diabetes prevention and targeted health policies.