Global, regional, and national burden of congenital anomalies of the kidney and urinary tract from 1990 to 2021, with projections to 2036: a systematic analysis of the global burden of disease study 2021

Abstract

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) represents an important global health challenge. However, the emerging analysis of the burden of CAKUT is limited and outdated. This study aimed to evaluate the global burden and temporal trends of CAKUT across 204 countries and territories from 1990 to 2021.

Methods: Data on the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of CAKUT from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. Temporal trends were analyzed using Joinpoint regression. The association between CAKUT burden and the socio-demographic index (SDI) was examined via Spearman correlation analysis. Decomposition analysis was used to estimate the effects of population growth, aging, and epidemiological changes on overall change of CAKUT burdens. The Bayesian age-period-cohort model was utilized to predict the CAKUT burden through 2036.

Results: From 1990 to 2021, the global prevalence of CAKUT increased by 21.50%, reaching 6.34 million (95% uncertainty interval [UI]: 5.07, 7.90), with a modest rise of 3.96% in the age-standardized prevalence rate (ASPR). In contrast, the incidence, mortality, and DALYs of CAKUT declined, with the age-standardized incidence rate (ASIR) decreasing by 2.86%, the age-standardized mortality rate (ASMR) by 20.00%, and the age-standardized DALY rate (ASDR) by 18.46%. In 2021, Southern Sub-Saharan Africa exhibited the highest ASPR and ASIR, while Central Latin America recorded the highest ASMR, and Southern Latin America had the highest ASDR. Furthermore, ASPR, ASIR, ASMR, and ASDR were all negatively correlated with SDI. Decomposition analysis revealed that population growth drove the increase in CAKUT prevalence. Projections to 2036 suggest further increases in ASPR and ASIR, whereas ASMR and ASDR are expected to decline.

Conclusion: Despite reductions in ASIR, ASMR, and ASDR, the increasing ASPR underscores the persistent global burden of CAKUT. Targeted interventions are urgently needed, particularly in high-burden regions such as Southern Sub-Saharan Africa.

Keywords: CAKUT; Disability-adjusted life years; Forecasting; Global burden of disease; Incidence; Mortality; Prevalence.