Chronic kidney disease (CKD) is increasingly linked to physical inactivity, highlighting widening health disparities across regions and populations.
Over the past 30 years, the incidence of CKD attributed to physical inactivity has surged, with global deaths and disability-adjusted life years (DALYs) increasing by more than 150%, according to a global analysis published in BMC Nephrology. This study tracked the CKD burden from 1990 to 2021, uncovering growing inequalities by region, gender, and age.
The American Kidney Fund (AKF) estimates that approximately 35.5 million people in the United States have kidney disease, making it the fastest-growing noncommunicable disease in the country. To help prevent kidney disease, AKF emphasizes several lifestyle modifications: maintaining a healthy weight, following kidney-friendly diet and fluid plans, undergoing kidney screening, and staying physically active.
Sharp Increase in Mortality and Disability
In 2021, over 40,900 global deaths from CKD were attributed to physical inactivity, along with more than 913,000 DALYs—both significantly higher than in 1990. The age-standardized death rate rose from 0.42 to 0.50 per 100,000, and the age-standardized DALY rate increased from 9.63 to 10.81 per 100,000. The estimated annual percentage change (EAPC) in deaths was 0.65%, indicating a steady upward trend.
During the study period, deaths due to inactivity-related CKD increased by 197%. Women were especially impacted, with a 200% increase in deaths compared to a 193% rise among men. In 2021, women accounted for more deaths (22,920) than men (17,990), and their DALY rate was also higher (9.63 vs. 7.15 per 100,000).
Socio-Demographic Inequalities
Regions with lower SDI bore the heaviest burden: a 103% increase in deaths and a 102% increase in DALYs. Although these regions saw a slight decline in average EAPC, the growth rate of the burden was still higher among women. In contrast, high-SDI regions had the smallest relative increases but still experienced a sharp 234% rise in deaths, especially among men.
Middle-SDI regions saw a 218% increase in deaths, while upper-middle SDI regions experienced a 168% rise. These patterns suggest that while more developed areas have seen larger absolute increases, low-income regions face more severe challenges, often lacking the healthcare infrastructure to manage them.
Regional Trends: The Americas Lead, Europe Lags
Among continents, the Americas had the largest increase: deaths rose by 282% and DALYs by 236%. The region also had the highest EAPC at 1.70%. Africa reported substantial increases, particularly among women, whose death toll rose by 174%.
In Europe, the CKD burden grew more modestly, with deaths increasing by 144% and DALYs by 76%. Although the male burden grew faster, overall growth was lower than in other continents. Asia reported a 194% increase in deaths, with a balanced burden between genders.
China, which holds nearly one-fifth of the world’s population, showed similar trends. Between 1990 and 2021, CKD deaths due to physical inactivity increased by 140%. While male growth slightly outpaced that of females, women still represented the larger share of total deaths (102,720 vs. 86,370 in 2021). China’s EAPC was slightly negative at -0.14%, indicating a recent slowdown in growth.
Age and Gender Differences
The study revealed clear age-related trends: CKD burden from inactivity was lower in younger people (ages 25–54) but increased sharply after age 55, peaking among those 85 and older. Across all age groups, lower-SDI countries faced heavier burdens than high-SDI countries, underscoring how economic development shapes health outcomes.
Overall, men had slightly higher death and DALY rates, but women consistently had higher absolute numbers, especially in low-SDI and African regions. This gender vulnerability highlights the need for targeted interventions, researchers noted.
“Due to lack of physical activity, the global burden of chronic kidney disease has increased significantly, especially among older adults, women, and low-income populations,” the authors wrote. “There is an urgent need to promote physical activity and implement early prevention strategies, particularly for vulnerable groups.”
As sedentary lifestyles persist worldwide, experts stress that even moderate physical activity can significantly help prevent CKD and improve global health—especially amid an aging population and widening healthcare disparities.
Related Topics
