Trends of national and sub-national burden attributed to kidney dysfunction risk factor in Iran: 1990-2019

Background Kidney dysfunction is a risk factor for cardiovascular disease and chronic kidney disease. Herein, we aimed to describe the attributable burden of kidney dysfunction at the national and sub-national levels in Iran. Methods The Global Burden of Disease (GBD) 2019 data were extracted on the deaths, disability-adjusted life years (DALYs), years of life lost, and years lived with disability attributed to the risk factor of kidney dysfunction by age and sex at the national and provincial levels from 1990-2019. Also, risk exposure was reported by summary exposure value (SEV) with a range of 0 to 100. The estimated values were based on a comparative risk assessment framework. Results In 2019, the age-standardized death rate and age-standardized DALYs rate attributable to kidney dysfunction were 58.2 (95% uncertainty interval of 48.8-68.1) and 1127.2 (981.1-1282.7) per 100,000 population in Iran, respectively. Also, the Sistan and Baluchistan province (1729.3 [1478.3-2006.4]) and the province of Tehran (681.9 [571.4-809.8]) had the greatest and lowest age-standardized DALYs rates, respectively. Nationally, SEVs increased from 22.8 to 26.2. The age-standardized burden attributable to kidney dysfunction had a positive association with age advancement. The attributable age-standardized deaths and DALYs rates in all socio-demographic index regions decreased from 1990-2019. Also, the highest and lowest attributable age-standardized DALYs rates of kidney dysfunction came from ischemic heart disease and peripheral artery disease in 2019, respectively. Conclusion Although the attributed age-standardized DALYs and death rates decreased from 1990-2019, risk exposure increased and remains a crucial risk factor in Iran. Therefore, policymakers should consider preparing a preventive program that takes into account different levels of prevention of kidney dysfunction.

[1]  H. Fallahzadeh,et al.  Prevalence of chronic kidney diseases and its determinants among Iranian adults: results of the first phase of Shahedieh cohort study , 2022, BMC Nephrology.

[2]  Ali Kazemi Karyani,et al.  Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019 , 2022, The Lancet.

[3]  F. Farzadfar,et al.  A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions , 2021, PloS one.

[4]  F. Farzadfar,et al.  Non-communicable diseases’ risk factors in Iran; a review of the present status and action plans , 2021, Journal of Diabetes & Metabolic Disorders.

[5]  Eun Sug Park,et al.  Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2020, Lancet.

[6]  Dan J Stein,et al.  Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2020, Lancet.

[7]  H. Fallahzadeh,et al.  Comparison of Sleep patterns in Menopausal and Non-menopausal Women: Results of the First Phase of Shahedieh Cohort Study , 2020 .

[8]  F. Farzadfar,et al.  Patterns of Obesity and Overweight in the Iranian Population: Findings of STEPs 2016 , 2020, Frontiers in Endocrinology.

[9]  A. Ghanbarzadegan,et al.  Ranking of Iranian provinces based on healthcare infrastructures: before and after implementation of Health Transformation Plan , 2020, Cost Effectiveness and Resource Allocation.

[10]  L. G. Vu,et al.  Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 , 2020, The Lancet.

[11]  F. Farzadfar,et al.  Physical activity profile of the Iranian population: STEPS survey, 2016 , 2019, BMC Public Health.

[12]  M. Yaseri,et al.  Prevalence of high blood pressure in Iranian adults based on the 2017 ACC/AHA guideline , 2019, Medical journal of the Islamic Republic of Iran.

[13]  M. Dabbaghmanesh,et al.  A Population-Based Study on the Prevalence and Risk Factors of Chronic Kidney Disease in the Adult Population of Shiraz, Southern Iran , 2019, Galen medical journal.

[14]  C. Thongprayoon,et al.  Association between urologic malignancies and end‐stage renal disease: A meta‐analysis , 2018, Nephrology.

[15]  J. Valdivielso,et al.  Sex hormones and their influence on chronic kidney disease , 2019, Current opinion in nephrology and hypertension.

[16]  F. Azizi,et al.  Dietary pattern and incidence of chronic kidney disease among adults: a population-based study , 2018, Nutrition & Metabolism.

[17]  F. Farzadfar,et al.  Salt intake among Iranian population: the first national report on salt intake in Iran , 2018, Journal of hypertension.

[18]  A. Maxwell,et al.  Chronic kidney disease, health-related quality of life and their associated economic burden among a nationally representative sample of community dwelling adults in England , 2018, PloS one.

[19]  Hong Xian,et al.  Changes in the US Burden of Chronic Kidney Disease From 2002 to 2016 , 2018, JAMA network open.

[20]  H. Dargahi,et al.  Patients’ complaints before and after implementation of health transformation plan , 2018 .

[21]  M. Hesaraki,et al.  Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta‐Analysis and Systematic Review , 2018, Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy.

[22]  S. Khodakarim,et al.  Urban-Rural Differences in the Prevalence of Self-Reported Diabetes and its Risk Factors: The WHO STEPS Iranian Noncommunicable Disease Risk Factor Surveillance in 2011 , 2017, Iranian journal of medical sciences.

[23]  R. Malekzadeh,et al.  Prevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort study , 2017, PloS one.

[24]  H. Najafipour,et al.  Assessment of Prevalence of Chronic Kidney Disease and Its Predisposing Factors in Kerman City , 2017 .

[25]  藤倉雄二,et al.  わが国における成人市中肺炎の原因微生物の変遷(Meta‐analysis and systematic review) , 2017 .

[26]  T. Vos,et al.  Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement , 2016, PLoS medicine.

[27]  M. Sayadi,et al.  Prevalence of chronic kidney disease and its contributing risk factors in southern Iran: a cross-sectional adult population-based study. , 2014, Iranian journal of kidney diseases.

[28]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[29]  Kai-Uwe Eckardt,et al.  Evolving importance of kidney disease: from subspecialty to global health burden , 2013, The Lancet.

[30]  R. Malekzadeh,et al.  Prevalence of chronic kidney disease and its associated risk factors: the first report from Iran using both microalbuminuria and urine sediment. , 2012, Archives of Iranian medicine.

[31]  M. Amini,et al.  Distribution of albuminuria and low glomerular filtration rate in a rural area, Shahreza, Iran. , 2011, Iranian journal of kidney diseases.

[32]  R. Malekzadeh,et al.  Renal Function and Risk Factors of Moderate to Severe Chronic Kidney Disease in Golestan Province, Northeast of Iran , 2010, PloS one.

[33]  M. Tonelli,et al.  Population based screening for chronic kidney disease: cost effectiveness study , 2010, BMJ : British Medical Journal.

[34]  S. Hatami,et al.  Screening for asymptomatic kidney disease in high-risk population of Urmia, Iran. , 2010, Iranian journal of kidney diseases.

[35]  M. Woodward,et al.  Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis , 2010, The Lancet.

[36]  M. Mahdavi-Mazdeh,et al.  Screening for Decreased Renal Function in Taxi Drivers in Tehran, Iran , 2010, Renal failure.

[37]  M. Woodward,et al.  Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis , 2010, The Lancet.

[38]  P. Mitchell,et al.  Association of CKD and cancer risk in older people. , 2009, Journal of the American Society of Nephrology : JASN.

[39]  F. Azizi,et al.  High prevalence of chronic kidney disease in Iran: a large population-based study , 2009, BMC public health.

[40]  M. Mahdavi-Mazdeh,et al.  Burden of chronic kidney disease in Iran: a screening program is of essential need. , 2008, Iranian journal of kidney diseases.

[41]  F. Schmidt Meta-Analysis , 2008 .

[42]  Charles E McCulloch,et al.  Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. , 2004, The New England journal of medicine.

[43]  J. McGill,et al.  Kidney Early Evaluation Program (KEEP) , 2004, The Diabetes educator.

[44]  M. Klag,et al.  Early detection of kidney disease in community settings: the Kidney Early Evaluation Program (KEEP). , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[45]  S. Leeder,et al.  A population based study , 1993, The Medical journal of Australia.