Chronic kidney disease now affects 788 million people worldwide, experts warn

Chronic kidney disease has quietly become one of the world's most widespread killers. A 2025 global analysis found that 788 million people now live with the condition, up from 378 million in 1990. For the first time, kidney disease has entered the top 10 leading causes of death worldwide.

Researchers from NYU Langone Health, the University of Glasgow, and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington led the study. The disease slowly weakens the kidneys' ability to remove waste and extra fluid from the blood. In early stages, people often feel nothing. In advanced stages, patients require dialysis, kidney replacement therapy, or a transplant.

The analysis, published in The Lancet and presented at the American Society of Nephrology's Kidney Week conference, examined 2,230 published research papers and health datasets from 133 countries. It stands as the most comprehensive global estimate of chronic kidney disease in nearly a decade. About 14% of adults worldwide carry the condition, researchers found.

In 2023 alone, roughly 1.5 million people died from chronic kidney disease. Deaths have risen more than 6% since 1993, after adjusting for age differences across countries. The condition also contributed to about 12% of all global cardiovascular deaths, making impaired kidney function a major risk factor for heart disease.

"Our work shows that chronic kidney disease is common, deadly, and getting worse as a major public health issue," said Josef Coresh, MD, PhD, director of NYU Langone's Optimal Aging Institute and study co-senior author. "These findings support efforts to recognize the condition alongside cancer, heart disease, and mental health concerns as a major priority for policymakers around the world."

The World Health Organization formally added chronic kidney disease to its agenda in May 2025 for reducing early deaths from noncommunicable diseases by one third before 2030. The study identified high blood sugar, high blood pressure, and obesity as the biggest risk factors. In 2023, chronic kidney disease ranked as the 12th leading cause of reduced quality of life from disability.

Most people with chronic kidney disease identified in the study were still in early stages, a finding that matters greatly. Early detection and treatment with medications and lifestyle changes can slow the disease and help patients avoid dialysis or transplantation. However, access to treatment remains uneven worldwide. In sub-Saharan Africa, Southeast Asia, Latin America, and other low-income regions, relatively few people receive dialysis or kidney transplants, largely because these treatments are less available and harder to afford.

"Chronic kidney disease is underdiagnosed and undertreated," said Morgan Grams, MD, PhD, study co-lead author and Susan and Morris Mark Professor of Medicine at the NYU Grossman School of Medicine. "Our report underscores the need for more urine testing to catch it early and the need to ensure that patients can afford and access therapy once they are diagnosed." Several medications introduced over the past five years can slow kidney disease and lower the risk of heart attack, stroke, and heart failure, Grams noted.

The problem may be larger than current estimates suggest. Many people with chronic kidney disease are never tested and therefore never diagnosed. Grams cautioned that the true scope of the disease likely exceeds the figures in the analysis. Since publication, kidney experts have projected that chronic kidney disease deaths could continue rising in the decades ahead, even as deaths from stroke and ischemic heart disease are expected to fall sharply.

Clinical guidance is evolving to address the growing threat. Kidney Disease: Improving Global Outcomes, an organization that develops widely used kidney care guidelines, has been updating its 2024 guidance to address new evidence on kidney protective treatments. These include SGLT2 inhibitors, GLP-1-based therapies, and nonsteroidal mineralocorticoid receptor antagonists in people with chronic kidney disease without diabetes. The shift reflects a new understanding: chronic kidney disease is no longer viewed only as a late-stage condition leading to dialysis or transplant, but as a quiet, common, and dangerous disorder that can be detected earlier and treated sooner.