About CKD

What is CKD?

Chronic Kidney Disease (CKD) is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health.

CKD is classified based on Cause, GFR category (G1–G5), and Albuminuria category (A1–A3), abbreviated as CGA. These 3 components of the classification system are each critical in the assessment of people with CKD and help enable determination of severity and risk.

Markers of kidney damage (one or more)	Albuminuria (AER ≥30 mg/g (≥3 mg/mmol)) Urine sediment abnormalities Electrolyte and other abnormalities due to tubular disorders Abnormalities detected by histology Structural abnormalities detected by imaging History of kidney transplantation
Decreased GFR	GFR <60 ml/min per 1.73 m2 (GFR categories G3a-G5)

Criteria for chronic kidney disease (CKD) (either of the following present for >3 months). AER, albumin excretion rate; GFR, glomerular filtration rate

Causes

Category	Examples of systemic diseases affecting the kidney	Examples of primary kidney diseases (absence of systemic diseases affecting the kidney)
Glomerular diseases	Diabetes, systemic autoimmune diseases, systemic infections, medications, neoplasia (including amyloidosis)	Diffuse, focal, or crescentic proliferative GN; focal and segmental glomerulosclerosis, membranous nephropathy, minimal change disease
Tubulo-interstitial diseases	Systemic infections, autoimmune, sarcoidosis, medications, urate, environmental toxins (lead, aristolochic acid), neoplasia (myeloma)	Urinary-tract infections, stones, obstruction, interstitial nephritis
Vascular diseases	Atherosclerosis, hypertension, ischemia, cholesterol emboli, systemic vasculitis, thrombotic microangiopathy, systemic sclerosis	ANCA-associated renal limited vasculitis, fibromuscular dysplasia
Cystic and congenital diseases	Polycystic kidney disease, Alport syndrome, Fabry disease	Renal dysplasia, medullary cystic disease, podocytopathies

GFR category	GFR (ml/min per 1.73 m2)	Terms
G1	≥90	Normal or high
G2	60-89	Mildly decreased
G3a	45-59	Mildly to moderately decreased
G3b	30-44	Moderately to severely decreased
G4	15-29	Severely decreased
G5	<15	Kidney failure

Albuminuria Category	AER (mg/24h)	ACR (approx. equ.)(mg/mmol)	ACR (approx. equ.)(mg/g)	Terms
A1	<30	<3	<30	Normal to mildly increased
A2	30-300	3-30	30-300	Moderately increased
A3	>300	>30	>300	Severely increased

Albuminuria Category	A1	A2	A3
AER (mg/24h)	<30	30-300	>300
ACR (approx. equ.)(mg/mmol)	<3	3-30	>30
ACR (approx. equ.)(mg/g)	<30	30-300	>300
Terms	Normal to mildly increased	Moderately increased	Severely increased

Risk Factors in CKD

Diabetes

High blood pressure

Heart (cardiovascular) disease

Smoking

Obesity

Being Black, Native American or Asian American

Family history of kidney disease

Abnormal kidney structure

Older age

Frequent use of medications that can damage the kidneys

Chronic Kidney Disease (CKD) is a growing health concern globally, with a high burden of morbidity and mortality.

Globally, in 2017, systematic analysis from the all-age GBD project found 697.5 million cases of all-stage CKD, for a global prevalence of 9.1%

Approximately 1 in 10

The Global Burden of Disease Study reported in 2017 that CKD was the 12th most common cause of death, accounting for 1.23 million deaths worldwide.

The worldwide age-standardised global prevalence of CKD per 100,000 population in 2016

CKD Prevalence in South East Asian Countries 2020

Countries	Prevalence %
Afghanistan	14.5
Pakistan	14.5
Bangladesh	19.8
Bhutan	15.4
Cambodia	11.2
Laos	11.2
Myanmar	11.2
India	15.7
Indonesia	8.6
Philippines	11.2
Timor-Leste	11.2
Viet Nam	8.7
North Korea	11.2
Brunei	18.2
Malaysia	18.2
China	14.5
Thailand	14.8
Sri Lanka	19.4
Maldives	17.8
Taiwan	22.6
Japan	26.5
Singapore	33.2
South Korea	17.8
Iran	13.7
Mongolia	7.8

Liyanage T, et al. BMJ Global Health 2022

CKD Prevalence in LATAM countries 2021

LATAM Countries	Prevalence %
Puerto Rico	15.39
British Virgin Islands	14.14
Cuba	11.98
Mexico	11.83
Colombia	10.73
El Salvador	10.67
Panama	10.65
Uruguay	10.63
Venezuela, RB	10.45
Chile	9.34
Argentina	9.33
Guatemala	8.39
Brazil	8.20
Dominican Republic	8.11
Paraguay	7.31
Peru	7.14
Bolivia	6.43
Haiti	6.29
Paraguay	7.31

Wainstein M.Bello A.K.Jha V.et al. Kidney Int Suppl 2021; 11: e35-e46

CKD Prevalence in African Countries

REGION	PREVALENCE OF CKD
Nigeria (2018)	24.4% - 26%
South Africa (2019)	12.9%
Egypt (2023)	13%
Tanzania (2018)	7%
Ethiopia (2018)	12.2%
Zimbabwe (2017)	2% - 41%
Cameroon (2020)	3.1 - 14.2%
Ivory Coast (2017)	10.4%
Botswana (2017)	13.5%
Guinea (2015)	4.8% - 11.7%

Appl. Sci. 2023, 13, 4924

CKD Prevalence in Middle Eastern Countries 2018

Countries	CKD Prevalence % (95% CI)
Bahrain	9.28
Iran, Islamic Rep.	10.57
Iraq	7.38
Jordan	7.37
Kuwait	8.39
Lebanon	8.31
Oman	7.42
Qatar	7.13
Saudi Arabia	7.2
Syrian Arab Republic	8.02
United Arab Emirates	7.67
West Bank and Gaza	-
Yemen	5.24

(http://www.healthdata.org/gbd), WHO data observatory (https://www.who.int/gho/en/)

CKD Prevalence in CIS Countries 2018

Countries	CKD Prevalence % (95% CI)
Armenia	14.89
Azerbaijan	11.26
Belarus	17.13
Georgia	12.55
Kazakhstan	10.42
Kyrgyz Republic	7.91
Russian Federation	19.23
Tajikistan	7.4
Turkmenistan	10.04
Ukraine	18.18
Uzbekistan	9.37

GBD study database (http://www.healthdata.org/gbd),WHO data observatory (https://www.who.int/gho/en/)