Global study reveals rising chronic kidney disease burden in women

Chronic kidney disease is now the seventh leading cause of death among noncommunicable diseases globally, affecting 11–13% of the adult population. While women consistently show a higher prevalence of CKD than men, most epidemiological analyses have pooled the sexes together, leaving the distinct patterns of CKD in women poorly understood. Women also face unique biological vulnerabilities-from faster disease progression after menopause to intergenerational risks linked to pregnancy complications-that demand tailored attention. 

To address these gaps, Professor Lin Sun and Professor Zhifeng Sheng from The Second Xiangya Hospital of Central South University conducted the first global analysis dedicated to CKD in women. Drawing on Global Burden of Disease 2021 data, the team quantified trends by age, CKD subtype, sociodemographic level, and risk factor, and further examined the cardiovascular consequences of impaired kidney function. Their findings were published in the Chinese Medical Journal on June 1, 2026. 

1. CKD in women: An underestimated "silent killer"
"Our analysis shows that the burden of CKD in women has not only grown, but has also transformed in character. Metabolic drivers-diabetes, hypertension, and obesity-now shape the trajectory of the disease," explains Prof. Sun. The number of women living with CKD climbed from about 188 million in 1990 to 359 million in 2021. Over the same period, deaths from CKD in women rose by 180.89%, and disability-adjusted life years (DALYs) increased by 114.00%. The age-standardized mortality and DALY rates both showed continuous upward trends, underscoring the worsening severity of the disease even after accounting for population growth and aging. 

2. Reproductive-age and postmenopausal women bear the major burden 
The study identified two populations at the heart of this global trend. Postmenopausal women (aged 50 years and older) bore the heaviest burden, accounting for nearly 90% of CKD-related deaths and about 73% of DALYs among women in 2021; both their age-standardized mortality rate (64.03 per 100,000) and DALY rate (1,493.31 per 100,000) continued to rise over the 32-year period. At the same time, women of reproductive age (15–49 years) emerged as a fast-growing risk group: their prevalent cases increased by 64.01%, and, uniquely among age groups, their age-standardized prevalence rate continued to climb (average annual percentage change, 0.13%). 

3. From risk to heart: Metabolic and behavioral drivers are modifiable targets 
Metabolic kidney disease showed the most alarming trajectory. Type 2 diabetic kidney disease recorded the largest increase in age-standardized mortality among all CKD subtypes (+36.93%), and hypertensive kidney disease prevalence effectively doubled. Metabolic risk factors-high fasting plasma glucose, high systolic blood pressure, and high body mass index-were the dominant attributable risks across all ages, with their combined impact approximately twice as large in women aged 50 and older as in younger women. Among reproductive-age women, the attributable burden linked to high body mass index more than doubled (+112.17%) and that linked to sugar-sweetened beverages rose by 132.97%, pointing to a widening metabolic vulnerability that begins well before midlife. 

4. Demographic drivers: Population growth and aging accelerate the CKD burden in women 
In 2021, cardiovascular disease attributable to impaired kidney function in women accounted for 18.19 million DALYs-about 46.70% of the total burden of kidney dysfunction in this population. Ischemic heart disease alone contributed roughly 60% of this cardiovascular burden, followed by cerebral hemorrhage and ischemic stroke. Geographical disparities were pronounced: women in low and low-middle sociodemographic regions carried the highest CKD burden, while high-income North America showed the fastest growth in CKD-related mortality. Decomposition analysis revealed that population growth (58.63%) and population aging (26.64%) were the principal engines driving the global rise in CKD-related DALYs.

5. Conclusion 
"Women face a converging metabolic–renal–cardiac threat that unfolds across the life course," concludes Prof. Sun. "Integrating kidney screening into preconception and antenatal care, tightening control of obesity, glucose, and blood pressure from young adulthood, and expanding access to kidney-protective therapies such as sodium–glucose cotransporter 2 inhibitors in low-resource settings will be essential to bend this curve." The authors call for sex-specific CKD registries, multidisciplinary cardio-kidney-metabolic clinics, and policy investment in women's kidney health as urgent next steps.