{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:04:07Z","timestamp":1790622247601,"version":"4.1.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>High body mass index (BMI) is a major modifiable risk factor for chronic kidney disease (CKD), significantly contributing to its global burden. This study aimed to systematically evaluate the global burden of CKD attributable to high BMI from 1990 to 2021, identify demographic and regional variations, evaluate contributing risk factors, and project future trends through 2035.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The population-based analysis utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, encompassing 204 countries and territories across 21 GBD regions. Age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) were assessed using percentage change (PC) and estimated annual percentage change (EAPC). Decomposition analysis quantified drivers of mortality and DALYs changes, while Bayesian age-period-cohort models projected future trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>From 1990 and 2021, the ASMR of CKD attributable to high BMI increased from 2.69 (95% UI: 1.37\u20134.14) to 5.06 (95% UI: 2.7\u20137.5) per 100,000, and the ASDR rose from 69.13 (95% UI: 35.06\u2013106) to 122.08 (95% UI: 66.25\u2013180.18) per 100,000. Projections estimate continued to increase by 2035, with ASMR reaching 5.81 (95% UI: 3.55\u20138.07) and ASDR 149.42 (95% UI: 99.45\u2013199.39) per 100,000. Sex and age disparities were evident: males showed higher ASR increases and earlier onset of disease burden, while older females experienced a higher overall burden. Regionally, low- and low-middle SDI areas exhibited the most rapid burden escalation, while some high-income countries achieved burden reduction. Among the attributable etiologies, hypertension and type 2 diabetes mellitus (T2DM) were predominant, with hypertension more common in males (42.05%) and T2DM in females (43.71%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The global burden of CKD attributable to high BMI has risen markedly over the past three decades, with widening disparities by geography, age, and sex. The COVID-19 pandemic may have further complicated risk dynamics and data quality. These findings highlight an urgent need for globally coordinated, locally adapted prevention strategies, particularly targeting younger males and populations in low-SDI regions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1611227","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T04:10:42Z","timestamp":1753157442000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Global burden and trends of high BMI-attributable chronic kidney disease: a comprehensive analysis from 1990 to 2021 and projections to 2035"],"prefix":"10.3389","volume":"12","author":[{"given":"Huifang","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoli","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinyin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1016\/S0140-6736(09)60318-4","article-title":"Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies","volume":"373","author":"Whitlock","year":"2009","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(24)00933-4","article-title":"Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1001\/jama.2024.2073","article-title":"One in 8 people worldwide are obese","volume":"331","author":"Anderer","year":"2024","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"396","year":"2020","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1467-789X.2009.00708.x","article-title":"Direct medical cost of overweight and obesity in the USA: a quantitative systematic review","volume":"12","author":"Tsai","year":"2011","journal-title":"Obes Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1136\/bmj.p523","article-title":"Global cost of overweight and obesity will hit $4.32tn a year by 2035, report warns","volume":"380","author":"Mahase","year":"2023","journal-title":"BMJ Clin Res Ed"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e009773","DOI":"10.1136\/bmjgh-2022-009773","article-title":"Economic impacts of overweight and obesity: current and future estimates for 161 countries","volume":"7","author":"Okunogbe","year":"2022","journal-title":"BMJ Glob Health"},{"key":"ref8","volume-title":"End-stage renal disease","author":"Hashmi","year":"2024"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1186\/s12889-025-21851-z","article-title":"Global, regional, and national burden of chronic kidney disease and its underlying etiologies from 1990 to 2021: a systematic analysis for the global burden of disease study 2021","volume":"25","author":"Deng","year":"2025","journal-title":"BMC Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"E24","DOI":"10.1152\/ajpendo.00179.2022","article-title":"Obesity and chronic kidney disease","volume":"324","author":"Jiang","year":"2023","journal-title":"Am J Phys Endocrinol Metab"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1007\/s13679-024-00583-y","article-title":"The kidney in obesity: current evidence, perspectives and controversies","volume":"13","author":"Kounatidis","year":"2024","journal-title":"Curr Obes Rep"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3787","DOI":"10.3390\/nu14183787","article-title":"Lifestyle-related risk factors for the incidence and progression of chronic kidney disease in the healthy young and middle-aged population","volume":"14","author":"Kuma","year":"2022","journal-title":"Nutrients"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1038\/s41581-024-00820-6","article-title":"Chronic kidney disease and the global public health agenda: an international consensus","volume":"20","author":"Francis","year":"2024","journal-title":"Nat Rev Nephrol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e382","DOI":"10.1016\/S2214-109X(23)00570-3","article-title":"An update on the global disparities in kidney disease burden and care across world countries and regions","volume":"12","author":"Bello","year":"2024","journal-title":"Lancet Glob Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1038\/s43016-023-00798-7","article-title":"Solutions to the double burden of malnutrition also generate health and environmental benefits","volume":"4","author":"Lopez Barrera","year":"2023","journal-title":"Nature Food"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"100625","DOI":"10.1016\/j.lana.2023.100625","article-title":"Reducing the gap of chronic kidney disease in low- and middle-income countries: what is missing?","volume":"28","author":"L\u00f3pez","year":"2023","journal-title":"Lancet Reg Health Am"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1016\/S0140-6736(24)00476-8","article-title":"Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the global burden of disease study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.kint.2018.04.011","article-title":"Analysis of the global burden of disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016","volume":"94","author":"Xie","year":"2018","journal-title":"Kidney Int"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"101078","DOI":"10.1016\/j.lanwpc.2024.101078","article-title":"Disease burden of Parkinson's disease in China and its provinces from 1990 to 2021: findings from the global burden of disease study 2021","volume":"46","author":"Xu","year":"2024","journal-title":"Lancet Reg Health West Pac"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40364-020-00195-3","article-title":"Trends and projections of kidney cancer incidence at the global and national levels, 1990-2030: a Bayesian age-period-cohort modeling study","volume":"8","author":"Du","year":"2020","journal-title":"Biomark Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"102382","DOI":"10.1016\/j.arr.2024.102382","article-title":"Trends and cross-country inequalities in the global burden of osteoarthritis, 1990-2019: A population-based study","volume":"99","author":"Cao","year":"2024","journal-title":"Ageing Res Rev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of chronic kidney disease: an update 2022","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int Suppl"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"102848","DOI":"10.1016\/j.eclinm.2024.102848","article-title":"Burden of disease attributable to high body mass index: an analysis of data from the global burden of disease study 2021","volume":"76","author":"Zhou","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1007\/s13679-023-00522-3","article-title":"Kidney considerations in pediatric obesity","volume":"12","author":"Sawyer","year":"2023","journal-title":"Curr Obes Rep"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"155999","DOI":"10.1016\/j.metabol.2024.155999","article-title":"Global burden of metabolic diseases, 1990\u20132021","volume":"160","author":"Zhang","year":"2024","journal-title":"Metab Clin Exp"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1193884","DOI":"10.3389\/fendo.2023.1193884","article-title":"Trends of the burden of type 2 diabetes mellitus attributable to high body mass index from 1990 to 2019 in China","volume":"14","author":"Wang","year":"2023","journal-title":"Front Endocrinol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e282","DOI":"10.1016\/S2468-2667(24)00053-7","article-title":"Differences across the lifespan between females and males in the top 20 causes of disease burden globally: a systematic analysis of the global burden of disease study 2021","volume":"9","author":"Patwardhan","year":"2024","journal-title":"Lancet Public Health"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/978-3-030-37668-0_11","article-title":"Gender differences in healthy and unhealthy life expectancy","volume-title":"International handbook of health expectancies","author":"Di Lego","year":"2020"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1016\/S0140-6736(13)60253-6","article-title":"Gender and global health: evidence, policy, and inconvenient truths","volume":"381","author":"Hawkes","year":"2013","journal-title":"Lancet"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s11883-018-0716-z","article-title":"Gender differences in epidemiology, pathophysiology, and treatment of hypertension","volume":"20","author":"Di Giosia","year":"2018","journal-title":"Curr Atheroscler Rep"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"100025","DOI":"10.1016\/j.medntd.2019.100025","article-title":"Gender differences in cardiovascular disease","volume":"4","author":"Gao","year":"2019","journal-title":"Med Novel Technol Devices"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2386","DOI":"10.1016\/S0140-6736(19)31295-4","article-title":"Gender equality: engaging men in change","volume":"393","author":"Flood","year":"2019","journal-title":"Lancet"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1038\/s41581-025-00928-3","article-title":"Approaches to raise awareness of CKD among patients and the general population","volume":"21","author":"Tuot","year":"2025","journal-title":"Nat Rev Nephrol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1053\/j.ajkd.2020.01.007","article-title":"CKD awareness among US adults by future risk of kidney failure","volume":"76","author":"Chu","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1111\/j.1467-789X.2009.00655.x","article-title":"Evidence of physical activity participation among men and women in the countries of the Gulf cooperation council: a review","volume":"11","author":"Mabry","year":"2010","journal-title":"Obes Rev"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s13098-017-0287-0","article-title":"Prevalence of overweight and obesity in United Arab Emirates expatriates: the UAE National Diabetes and lifestyle study","volume":"9","author":"Sulaiman","year":"2017","journal-title":"Diabetol Metab Syndr"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1016\/S0140-6736(19)30041-8","article-title":"Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the global burden of disease study 2017","volume":"393","year":"2019","journal-title":"Lancet"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1038\/s42949-021-00023-z","article-title":"Ageing and population shrinking: implications for sustainability in the urban century","volume":"1","author":"Jarzebski","year":"2021","journal-title":"Npj Urban Sustain"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"334","DOI":"10.3390\/ijerph18010334","article-title":"Public health innovation through cloud adoption: A comparative analysis of drivers and barriers in Japan, South Korea, and Singapore","volume":"18","author":"Raghavan","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1007\/s13679-019-00358-w","article-title":"Global implementation of obesity prevention policies: a review of Progress, politics, and the path forward","volume":"8","author":"Lyn","year":"2019","journal-title":"Curr Obes Rep"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"411","DOI":"10.23876\/j.krcp.23.194","article-title":"The burden of chronic kidney disease in Asia region: a review of the evidence, current challenges, and future directions","volume":"44","author":"Makmun","year":"2024","journal-title":"Korean J Nephrol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1111\/obr.12098","article-title":"A food policy package for healthy diets and the prevention of obesity and diet-related non-communicable diseases: the NOURISHING framework","volume":"14","author":"Hawkes","year":"2013","journal-title":"Obes Rev"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1522555","DOI":"10.3389\/fnut.2024.1522555","article-title":"Global burden of chronic kidney disease due to dietary factors","volume":"11","author":"Yin","year":"2024","journal-title":"Front Nutr"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"14790","DOI":"10.1038\/s41598-020-71908-9","article-title":"Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025","volume":"10","author":"Lin","year":"2020","journal-title":"Sci Rep"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/S0140-6736(07)61696-1","article-title":"The burden and costs of chronic diseases in low-income and middle-income countries","volume":"370","author":"Abegunde","year":"2007","journal-title":"Lancet"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1161\/CIRCULATIONAHA.115.018585","article-title":"Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: A comprehensive review","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1016\/S0140-6736(23)00011-9","article-title":"Commercial determinants of health: future directions","volume":"401","author":"Friel","year":"2023","journal-title":"Lancet"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"2058","DOI":"10.1038\/s41591-024-03015-5","article-title":"Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial","volume":"30","author":"Colhoun","year":"2024","journal-title":"Nat Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"3969","DOI":"10.3390\/ijms25073969","article-title":"Molecular targets of novel therapeutics for diabetic kidney disease: a new era of nephroprotection","volume":"25","author":"Mazzieri","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1161\/HYPERTENSIONAHA.120.14868","article-title":"Endogenous activation of glucagon-like peptide-1 receptor contributes to blood pressure control: role of proximal tubule Na(+)\/H(+) exchanger isoform 3, renal angiotensin II, and insulin sensitivity","volume":"76","author":"Martins","year":"2020","journal-title":"Hypertension"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1611227\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:19:49Z","timestamp":1753366789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1611227\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,22]]},"references-count":52,"alternative-id":["10.3389\/fnut.2025.1611227"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1611227","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,22]]},"article-number":"1611227"}}