Global, regional, and national burden of chronic kidney disease attributable to dietary risks, 1990 to 2021

Dietary risks are key modifiable contributors to chronic kidney disease (CKD) worldwide; however, their association with geographic or socioeconomic status remains underexplored. We aimed to quantify the global, regional, and national burden of CKD attributable to dietary risks from 1990 to 2021 using estimates from the Global Burden of Disease Study (GBD) 2021. Estimates of disability-adjusted life-years (DALYs) of CKD attributable to dietary risks were stratified by age, sex, location, and Socio-demographic Index (SDI) across 204 countries and territories from 1990 to 2021. We performed a comprehensive risk assessment for 7 dietary factors of CKD stratified by underlying causes: CKD due to type 2 diabetes mellitus (T2DM), hypertension, glomerulonephritis, and other unspecified causes. Every DALY estimate was accompanied by a 95% uncertainty interval. In 2021, the global age-standardized DALY rates of CKD attributable to dietary risks were 93.52 (95% uncertainty interval, 54.29-134.38) per 1,00,000. The leading dietary contributors were low fruit (38.68 [20.15-57.77] per 1,00,000) and vegetable (30.84 [14.80-50.20]) intake and high sodium (19.81 [2.51-54.57]) intake. The DALY rates increased sharply with age, with higher rates among males, reaching 920.46 in males and 840.16 in females at ages 95 years or above for low fruit intake. Low SDI regions showed a higher burden from CKD due to hypertension, attributable to fruit (54.23) and vegetable (55.99) deficiencies, while high SDI regions exhibited a greater burden from CKD due to T2DM, attributable to highly processed meat (11.36) and a relatively high burden from red meat (6.59) and sugar-sweetened beverages (4.01), with the greatest increase from high sugar-sweetened beverage intake (121.08%). The global burden of CKD attributable to dietary risk remains substantial, with persistent disparities in age, sex, location, and SDI. Targeted dietary strategies are needed to address these disparities and reduce the CKD burden worldwide.