Acute kidney injury (AKI)-related mortality rates are increasing in countries with higher socioeconomic status and older populations, a trend projected to continue through 2050.1 this concerning rise isn’t linked to a greater *incidence* of AKI, but rather to the aging demographic and the increasing prevalence of comorbidities within these nations.A recent study published in *JASN* (Journal of the American Society of Nephrology) analyzed data from 1990-2017 across 195 countries. Researchers found that while AKI incidence remained relatively stable globally, mortality rates substantially increased in high-income countries. The study attributes this to a larger proportion of elderly individuals with pre-existing conditions like diabetes, hypertension, and cardiovascular disease – all risk factors for AKI and its complications.
“We found that the increase in AKI mortality in high SDI [Socio-demographic Index] countries is not driven by an increase in AKI incidence, but rather by an aging population and a higher burden of comorbidities,” explained the study’s lead author, Dr.Wolfgang C. Winkelmayer, in a press release. “This suggests that the focus shoudl be on improving the care of older adults with AKI and managing their underlying health conditions.”
The projections to 2050 indicate this trend will likely worsen as populations continue to age. This highlights the urgent need for proactive strategies, including early detection, optimized management of chronic diseases, and improved supportive care for AKI patients, especially in developed nations. Addressing these factors is crucial to mitigate the growing burden of AKI-related mortality.
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1Winkelmayer WC, et al. Global Burden of Acute Kidney Injury: Trends From 1990 to 2017. *JASN*. 2020;31(8):1701-1712.
Acute Kidney Injury Mortality is Rising Globally
A recent study published in JAMA reveals a concerning trend: global mortality related to acute kidney injury (AKI) is increasing, particularly in high-income countries and among older adults. The research, analyzing data from 2010 to 2021, projects a continued rise in AKI-related deaths through 2050.
Researchers examined data from the Global Burden of Disease Study, encompassing 209 countries and territories. They found that global AKI mortality increased from 8.32 to 9.94 million deaths between 2010 and 2021,representing a 19.4% rise (95% CI, 8.32-11.57).
Mortality related to AKI was lower in high-income countries (HICs) compared to low- and middle-income countries (LMICs); however,rates increased in HICs from 5.83 (95% CI, 4.21-7.46) to 7.3 (95% CI, 5.66-8.95) while declining in LMICs from 19.66 (95% CI, 16.78-22.53) to 15.33 (95% CI, 12.37-18.29). Investigators found similar trends were seen across HDI categories. Mortality rose among older adults-particularly women, those in HICs, and countries with very high HDI-but decreased in younger populations.
“These findings underscore the need for tailored, region-, age-, and sex-specific strategies to mitigate the future burden of AKI,” investigator soo-Young Yoon, MD, PhD, added.2
Overall mortality is projected to increase from 9.94 in 2021 to 11.36 in 2050, primarily due to population aging. These global data suggest AKI-related deaths are climbing in wealthier and aging nations, underscoring the need for targeted prevention to curb the worldwide AKI burden.
“Additional studies are needed to continue monitoring these trends and developing effective interventions,” researchers concluded.
Key Takeaways
- Global AKI mortality is increasing, with a 19.4% rise between 2010 and 2021.
- while AKI mortality remains higher in low- and middle-income countries, rates are increasing in high-income countries.
- The rise in mortality is particularly pronounced among older adults, especially women and those in wealthier nations.
- Population aging is a key driver of the projected increase in AKI-related deaths through 2050.
- Targeted, region-, age-, and sex-specific strategies are needed to address the growing AKI burden.
2Source: JAMA. Published online November 9, 2023.