Mortality and disability-adjusted life years in North Africa and Middle East attributed to kidney dysfunction: a systematic analysis for the Global Burden of Disease Study 2019
Authors: Rashidi Mohammad-Mahdi , Saeedi Moghaddam Sahar , Azadnajafabad Sina , Mohammadi Esmaeil , Khalaji Amirmohammad , Malekpour Mohammad-Reza , Keykhaei Mohammad , Rezaei Negar , Esfahani Zahra , Rezaei Nazila ,   GBD 2019 NAME Kidney Dysfunction Risk Factor Collaborators, Rashidi Mohammad-Mahdi , Moghaddam Sahar Saeedi , Azadnajafabad Sina , Mohammadi Esmaeil , Khalaji Amirmohammad , Malekpour Mohammad-Reza , Keykhaei Mohammad , Rezaei Negar , Esfahani Zahra , Rezaei Nazila , Abbasi-Kangevari Mohsen , Abbasi-Kangevari Zeinab , ElHafeez Samar Abd , Abd-Elsalam Sherief , Abdoun Meriem , Abu-Gharbieh Eman , Ahmad Aqeel , Ahmed Ayman , Al-Azzam Sayer , Al-Raddadi Rajaa M , Al-Tammemi Ala'a B , Dehkordi Javad Aminian , Amir-Behghadami Mehrdad , Arabloo Jalal , Athar Mohammad , Athari Seyyed Shamsadin , Babaei Mahsa , Babamohamadi Hassan , Baghcheghi Nayereh , Bagherieh Sara , Baradaran Hamid Reza , Bhagavathula Akshaya Srikanth , Bhojaraja Vijayalakshmi S , Hashemi Milad Bonakdar , Campos Luciana Aparecida , Dehghan Azizallah , Elhadi Muhammed , El-Huneidi Waseem , Fatehizadeh Ali , Feizkhah Alireza , Ghadirian Fataneh , Gholami Ali , Hamidi Samer , Hassankhani Hadi , Heidari-Foroozan Mahsa , Hessami Kamran , Hezam Kamal , Hosseini Mohammad-Salar , Hoveidamanesh Soodabeh , Irilouzadian Rana , Jahrami Haitham , Jamialahmadi Tannaz , Jayapal Sathish Kumar , Karasneh Reema A , Khan Moien A B , Khan Yusra H , Khatatbeh Moawiah Mohammad , Kompani Farzad , Koohestani Hamid Reza , Kuddus Mohammed , Mahjoub Soleiman , Mahmoodpoor Ata , Rad Elaheh Malakan , Malik Ahmad Azam , Mallhi Tauqeer Hussain , Mobayen Mohammadreza , Mohammadi Faezeh , Mohan Syam , Momtazmanesh Sara , Natto Zuhair S , Nejadghaderi Seyed Aria , Okati-Aliabad Hassan , Rashedi Sina , Rashidi Amirfarzan , Rashidi Mahsa , Redwan Elrashdy Moustafa Mohamed , Saad Aly M A , Sharif-Askari Fatemeh Saheb , Sahebkar Amirhossein , Saki Morteza , Samy Abdallah M , Shaker Elaheh , Shetty Jeevan K , Shorofi Seyed Afshin , Tabish Mohammad , Taherkhani Amir , Umair Muhammad , Vahabi Seyed Mohammad , Yazdanpanah Fereshteh , Yigit Arzu , Zahir Mazyar , Zangiabadian Moein , Mokdad Ali H , Murray Christopher J L , Naghavi Mohsen , Larijani Bagher , Farzadfar Farshad , Mokdad Ali H , Murray Christopher J L , Naghavi Mohsen , Larijani Bagher , Farzadfar Farshad 
Published: November 2023

ABSTRACT

Background
The study aimed to estimate the attributable burden to kidney dysfunction as a metabolic risk factor in the North Africa and Middle East (NAME) region and its 21 countries in 1990–2019.

Methods
The data used in this study were obtained from the Global Burden of Diseases (GBD) 2019 study, which provided estimated measures of deaths, disability-adjusted life years (DALYs), and other epidemiological indicators of burden. To provide a better insight into the differences in the level of social, cultural, and economic factors, the Socio-Demographic Index (SDI) was used.

Results
In the NAME region in 2019, the number of deaths attributed to kidney dysfunction was 296 632 (95% uncertainty interval: 249 965–343 962), which was about 2.5 times higher than in the year 1990. Afghanistan, Egypt, and Saudi Arabia had the highest, and Kuwait, Turkey, and Iran (Islamic Republic of) had the lowest age-standardized rate of DALYs attributed to kidney dysfunction in the region in 2019. Kidney dysfunction was accounted as a risk factor for ischemic heart disease, chronic kidney disease, stroke, and peripheral artery disease with 150 471, 111 812, 34 068, and 281 attributable deaths, respectively, in 2019 in the region. In 2019, both low-SDI and high-SDI countries in the region experienced higher burdens associated with kidney dysfunction compared to other countries.

Conclusions
Kidney dysfunction increases the risk of cardiovascular diseases burden and accounted for more deaths attributable to cardiovascular diseases than chronic kidney disease in the region in 2019. Hence, policymakers in the NAME region should prioritize kidney disease prevention and control, recognizing that neglecting its impact on other diseases is a key limitation in its management.