{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:04:41Z","timestamp":1793379881643,"version":"4.5.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic kidney disease (CKD) due to hypertension represents a major global health challenge, with lead exposure exacerbating this burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to analyze the global burden of lead-attributable hypertensive CKD from 1990 to 2021 and project trends over the next 15 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data from the Global Burden of Disease (GBD) 2021 study were utilized, focusing on mortality and disability-adjusted life years (DALYs). Trends were analyzed across 204 countries\/territories, categorized into 21 GBD regions and five socio-demographic index (SDI) quintiles. Detailed analyses of case numbers, age-standardized rates (ASRs), age groups, sex differences, and temporal trends were conducted. Pearson correlation analysis was applied to assess the association between SDI and disease burden, frontier analysis was used to evaluate country-specific burden levels, and autoregressive integrated moving average (ARIMA) models were employed to project future trends (2021\u20132036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1990 to 2021, global deaths from lead-attributable hypertensive CKD increased from 16,932 to 52,839 (a 212.07% rise), with age-standardized mortality rate increasing from 0.481 to 0.641 per 100,000 (EAPC = 1.05). DALYs rose from nearly 470,000 to 1.17 million (a 150.98% increase), with age-standardized DALYs rate increasing from 11.825 to 13.725 per 100,000 (EAPC = 0.55), with marked regional disparities. Older adults and males bore a heavier burden. The highest burdens were observed in low SDI regions, while high SDI regions had the lowest burdens, with a minor inflection point at an SDI of approximately 0.5. Frontier analysis revealed substantial heterogeneity in disease burden across countries. Projection analyses indicated a potential reduction in disease burden over the next 15 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Addressing lead exposure is critical to mitigating the burden of CKD due to hypertension. Targeted interventions tailored to SDI levels and lessons from frontier-line countries are recommended to achieve equitable burden reduction.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1635877","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T05:30:24Z","timestamp":1758605424000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of lead exposure on global chronic kidney disease attributable to hypertension: deaths and disability-adjusted life years from 1990 to 2021 and projected trends for 2022\u20132036"],"prefix":"10.3389","volume":"13","author":[{"given":"Yujun","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaling","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bowen","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiujie","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Mai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"130","DOI":"10.20452\/pamw.15150","article-title":"Hypertensive kidney disease: a true epidemic or rare disease?","volume":"130","author":"Stomp\u00f3r","year":"2020","journal-title":"Pol Arch Intern Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"153","DOI":"10.3892\/etm.2023.11852","article-title":"Role of arterial hypertension and angiotensin II in chronic kidney disease","volume":"25","author":"Maranduca","year":"2023","journal-title":"Exp Ther Med."},{"key":"B3","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":"B4","doi-asserted-by":"publisher","first-page":"690487","DOI":"10.3389\/fmed.2021.690487","article-title":"Disease burden of chronic kidney disease due to hypertension from 1990 to 2019: a global analysis","volume":"8","author":"Chen","year":"2021","journal-title":"Front Med (Lausanne)."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2694","DOI":"10.1093\/ndt\/gfad118","article-title":"Hypertension in chronic kidney disease\u2014treatment standard 2023","volume":"38","author":"Georgianos","year":"2023","journal-title":"Nephrol Dial Transplant."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.3390\/foods10061158","article-title":"Human exposure to toxic metals (Al, Cd, Cr, Ni, Pb, Sr) from the consumption of cereals in Canary Islands","volume":"10","author":"Rubio-Armend\u00e1riz","year":"2021","journal-title":"Foods."},{"key":"B7","doi-asserted-by":"publisher","first-page":"675","DOI":"10.33963\/KP.a2023.0142","article-title":"Blood pressure and hypertension in relation to lead exposure updated according to present-day blood lead levels","volume":"81","author":"Yu","year":"2023","journal-title":"Kardiol Pol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"23230","DOI":"10.1038\/s41598-024-73724-x","article-title":"Association of urinary and blood lead concentrations with all-cause mortality in US adults with chronic kidney disease: a prospective cohort study","volume":"14","author":"Li","year":"2024","journal-title":"Sci Rep."},{"key":"B9","doi-asserted-by":"publisher","first-page":"168189","DOI":"10.1016\/j.scitotenv.2023.168189","article-title":"systematic analysis of chronic kidney disease burden attributable to lead exposure based on the global burden of disease study 2019","volume":"908","author":"Song","year":"2024","journal-title":"Sci Total Environ."},{"key":"B10","doi-asserted-by":"publisher","first-page":"975413","DOI":"10.3389\/fpubh.2022.975413","article-title":"Lead exposure is non-linearly associated with subclinical myocardial injury in the general population without cardiovascular disease","volume":"10","author":"Wang","year":"2022","journal-title":"Front Public Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"13107","DOI":"10.1021\/acs.est.2c03767","article-title":"Provenance of Anthropogenic Pb and Atmospheric Dust to Northwestern North America","volume":"56","author":"Koffman","year":"2022","journal-title":"Environ Sci Technol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1186\/s13045-024-01640-8","article-title":"Global burden of cancer and associated risk factors in 204 countries and territories, 1980\u20132021: a systematic analysis for the GBD 2021","volume":"17","author":"Wu","year":"2024","journal-title":"J Hematol Oncol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1526482","DOI":"10.3389\/fendo.2025.1526482","article-title":"Global, regional, and national burden of chronic kidney disease, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"16","author":"Xie","year":"2025","journal-title":"Front Endocrinol (Lausanne)."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1951","DOI":"10.1097\/JS9.0000000000001071","article-title":"Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030","volume":"110","author":"Wang","year":"2024","journal-title":"Int J Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1102673","DOI":"10.3389\/fonc.2023.1102673","article-title":"systematic analysis of the global and regional burden of colon and rectum cancer and the difference between early- and late-onset CRC from 1990 to 2019","volume":"13","author":"Li","year":"2023","journal-title":"Front Oncol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1080\/07853890.2022.2074535","article-title":"Global, regional and national burden of gastroesophageal reflux disease, 1990-2019: update from the GBD 2019 study","volume":"54","author":"Zhang","year":"2022","journal-title":"Ann Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"102124","DOI":"10.1016\/j.arr.2023.102124","article-title":"Global, regional, and national prevalence of hearing loss from 1990 to 2019: a trend and health inequality analyses based on the Global Burden of Disease Study 2019","volume":"92","author":"Jiang","year":"2023","journal-title":"Ageing Res Rev."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e00406","DOI":"10.14309\/ctg.0000000000000406","article-title":"Global burden and trends in incidence, mortality, and disability of stomach cancer from 1990 to 2017","volume":"12","author":"Qin","year":"2021","journal-title":"Clin Transl Gastroenterol."},{"key":"B19","article-title":"Comparison of estimated annual percentage change with average growth rate in public health applications","author":"Zhang","year":"2015","journal-title":"Chin J Health Stat."},{"key":"B20","doi-asserted-by":"publisher","first-page":"102598","DOI":"10.1016\/j.arr.2024.102598","article-title":"Global, regional, and national burden of spinal cord injury from 1990 to 2021 and projections for 2050: a systematic analysis for the Global Burden of Disease 2021 study","volume":"103","author":"Lu","year":"2024","journal-title":"Ageing Res Rev."},{"key":"B21","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":"B22","doi-asserted-by":"publisher","first-page":"103674","DOI":"10.1016\/j.autrev.2024.103674","article-title":"Global burden due to modifiable risk factors for autoimmune diseases, 1990-2021: temporal trends and socio-demographic inequalities","volume":"23","author":"Guan","year":"2024","journal-title":"Autoimmun Rev."},{"key":"B23","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.compeleceng.2019.04.013","article-title":"A smart system for short-term price prediction using time series models","volume":"76","author":"Nguyen","year":"2019","journal-title":"Comput Electr Eng."},{"key":"B24","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1093\/ckj\/sfac218","article-title":"Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019","volume":"16","author":"Li","year":"2022","journal-title":"Clin Kidney J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"2351","DOI":"10.3390\/ijerph15112351","article-title":"Lead exposure in low and middle-income countries: perspectives and lessons on patterns, injustices, economics, and politics","volume":"15","author":"Kordas","year":"2018","journal-title":"Int J Environ Res Public Health."},{"key":"B26","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.envint.2018.08.052","article-title":"Lead-based paint remains a major public health concern: a critical review of global production, trade, use, exposure, health risk, and implications","volume":"121","author":"O'Connor","year":"2018","journal-title":"Environ Int."},{"key":"B27","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s12940-022-00914-3","article-title":"Estimating the burden of diseases attributable to lead exposure in the North Africa and Middle East region, 1990-2019: a systematic analysis for the Global Burden of Disease study 2019","volume":"21","author":"Rezaee","year":"2022","journal-title":"Environ Health."},{"key":"B28","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12940-025-01155-w","article-title":"The burden and trend prediction of ischemic heart disease associated with lead exposure: insights from the Global Burden of Disease study 2021","volume":"24","author":"Ding","year":"2025","journal-title":"Environ Health."},{"key":"B29","doi-asserted-by":"publisher","first-page":"117908","DOI":"10.1016\/j.ecoenv.2025.117908","article-title":"Disparities in global disease burden attributed to ambient particulate matter pollution and household air pollution from solid fuels","volume":"291","author":"Liu","year":"2025","journal-title":"Ecotoxicol Environ Saf."},{"key":"B30","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1186\/s12872-024-04390-0","article-title":"Cardiovascular disease burden in the North Africa and Middle East region: an analysis of the global burden of disease study 1990-2021","volume":"24","author":"Soleimani","year":"2024","journal-title":"BMC Cardiovasc Disord."},{"key":"B31","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1038\/s41440-022-01069-x","article-title":"Public and occupational health risks related to lead exposure updated according to present-day blood lead levels","volume":"46","author":"Yu","year":"2023","journal-title":"Hypertens Res."},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jare.2025.04.004.","article-title":"Global, regional, and national burden of neglected tropical diseases and malaria in the general population, 1990-2021: systematic analysis of the global burden of disease study 2021","author":"Zheng","year":"2025","journal-title":"J Adv Res"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1567275","DOI":"10.3389\/fpubh.2025.1567275","article-title":"Global, regional, and national trends in ischaemic stroke burden and risk factors among adults aged 20 + years (1990-2021): a systematic analysis of data from the Global Burden of Disease study 2021 with projections into 2050","volume":"13","author":"Liu","year":"2025","journal-title":"Front Public Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1093\/aje\/kwq428","article-title":"Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989-2007","volume":"173","author":"Jones-Smith","year":"2011","journal-title":"Am J Epidemiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"e385","DOI":"10.1016\/S2214-109X(23)00007-4","article-title":"Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026","volume":"11","year":"2023","journal-title":"Lancet Glob Health"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e029375","DOI":"10.1161\/JAHA.123.029375","article-title":"Particulate matter pollution remains a threat for cardiovascular health: findings from the global burden of disease 2019","volume":"12","author":"Moradi","year":"2023","journal-title":"J Am Heart Assoc."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1186\/s12889-023-15874-7","article-title":"Patterns of global burden of 13 diseases attributable to lead exposure, 1990\u20132019","volume":"23","author":"Xu","year":"2023","journal-title":"BMC Public Health."},{"key":"B38","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1136\/oemed-2018-105469","article-title":"Population-based study of amyotrophic lateral sclerosis and occupational lead exposure in Denmark","volume":"76","author":"Dickerson","year":"2019","journal-title":"Occup Environ Med."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1007\/s12011-022-03248-w","article-title":"The effect of smoking habits on blood cadmium and lead levels in residents living near a mining and smelting area in Northwest China: a cross-sectional study","volume":"201","author":"Dai","year":"2023","journal-title":"Biol Trace Elem Res."},{"key":"B40","doi-asserted-by":"publisher","first-page":"17116","DOI":"10.1038\/s41598-024-70628-8","article-title":"Sex differences in disease burden, utilization, and expenditure on primary health care services in Kerala, India","volume":"15","author":"Joseph","year":"2025","journal-title":"Sci Rep."},{"key":"B41","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1002\/ajim.23483","article-title":"Health conditions among male workers in mining and other industries reliant on manual labor occupations: National Health Interview Survey, 2007-2018","volume":"66","author":"Robinson","year":"2023","journal-title":"Am J Ind Med."},{"key":"B42","unstructured":"Fatmi\n              Z\n            \n          \n          Lead Content in \u2018Surma\/Kajal Samples' from Japan, Pakistan and Saudi Arabia\n          \n          2018"},{"key":"B43","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1111\/j.1440-1584.2012.01287.x","article-title":"Prevalence of hypertension and pre-hypertension in rural women: a report from the villages of West Bengal, a state in the eastern part of India","volume":"20","author":"Dutta","year":"2012","journal-title":"Aust J Rural Health."},{"key":"B44","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.semnephrol.2019.02.001","article-title":"Environmental and Occupational Exposures in Kidney Disease","volume":"39","author":"Scammell","year":"2019","journal-title":"Semin Nephrol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41371-022-00751-4","article-title":"Hypertension and cardiomyopathy associated with chronic kidney disease: epidemiology, pathogenesis and treatment considerations","volume":"37","author":"Law","year":"2023","journal-title":"J Hum Hypertens."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1289\/ehp.7024","article-title":"Lead, diabetes, hypertension, and renal function: the normative aging study","volume":"112","author":"Tsaih","year":"2004","journal-title":"Environ Health Perspect."},{"key":"B47","doi-asserted-by":"publisher","first-page":"2261","DOI":"10.1007\/s10661-011-2115-6","article-title":"Impacts of lead\/zinc mining and smelting on the environment and human health in China","volume":"184","author":"Zhang","year":"2012","journal-title":"Environ Monit Assess."},{"key":"B48","doi-asserted-by":"publisher","first-page":"e905","DOI":"10.1016\/S2542-5196(21)00263-1","article-title":"Health consequences of exposure to e-waste: an updated systematic review","volume":"5","author":"Parvez","year":"2021","journal-title":"Lancet Planet Health."},{"key":"B49","unstructured":"Electronic Waste (e-waste)"},{"key":"B50","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1093\/eurpub\/ckae010","article-title":"Global health inequality: analyses of life disparity and healthy life disparity","volume":"34","author":"Zheng","year":"2024","journal-title":"Eur J Public Health."},{"key":"B51","doi-asserted-by":"publisher","first-page":"138207","DOI":"10.1016\/j.chemosphere.2023.138207","article-title":"Global decrease in blood lead concentrations due to the removal of leaded gasoline","volume":"324","author":"Lacerda","year":"2023","journal-title":"Chemosphere."},{"key":"B52","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/s12940-022-00936-x","article-title":"Relation of blood lead levels and lead in gasoline: an updated systematic review","volume":"21","author":"Angrand","year":"2022","journal-title":"Environ Health."},{"key":"B53","doi-asserted-by":"publisher","first-page":"29778","DOI":"10.1007\/s11356-021-17560-w","article-title":"The environmental impact of industrialization and foreign direct investment: empirical evidence from Asia-Pacific region","volume":"29","author":"Ahmed","year":"2022","journal-title":"Environ Sci Pollut Res Int."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1186\/s12889-023-16198-2","article-title":"The societal cost of modifiable risk factors in Singapore","volume":"23","author":"Tan","year":"2023","journal-title":"BMC Public Health."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1186\/s12889-025-22421-z","article-title":"Examining factors contributing to mortality in Saudi Arabia: proposing effective healthcare management approaches","volume":"25","author":"Aljarid","year":"2025","journal-title":"BMC Public Health."},{"key":"B56","unstructured":"University of Gothenburg (2024)"},{"key":"B57","doi-asserted-by":"publisher","first-page":"r759","DOI":"10.1136\/bmj.r759","article-title":"Afghanistan's fragile health system faces catastrophe without immediate international funding","volume":"389","author":"Turkmani","year":"2025","journal-title":"BMJ"},{"key":"B58","doi-asserted-by":"publisher","first-page":"140375","DOI":"10.1016\/j.scitotenv.2020.140375","article-title":"Mining in Papua New Guinea: a complex story of trends, impacts and governance","volume":"741","author":"Mudd","year":"2020","journal-title":"Sci Total Environ."},{"key":"B59","doi-asserted-by":"publisher","first-page":"280","DOI":"10.11604\/pamj.2017.27.280.12080","article-title":"Knowledge and perceptions of health and environmental risks related to artisanal gold mining by the artisanal miners in Burkina Faso: a cross-sectional survey","volume":"27","author":"Sana","year":"2017","journal-title":"Pan Afr Med J."},{"key":"B60","doi-asserted-by":"publisher","first-page":"415160","DOI":"10.1155\/2014\/415160","article-title":"Lead exposure: a summary of global studies and the need for new studies from Saudi Arabia","volume":"2014","author":"Shaik","year":"2014","journal-title":"Dis Markers."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1635877\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T05:30:27Z","timestamp":1758605427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1635877\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2025.1635877"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1635877","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,23]]},"article-number":"1635877"}}