Authors: Aya Abdulrahman Ajeel , Abdullah I. Alzimam , Sharifah Alraythi , Ahmad Mohammad Mahmoud Altatari , Abdullah bousamri , Khalid Aldubaiyan , Ali Mesfer Almatri , Naif Aljamlan , Muhannad Omar Banaeamh , Hisham Ali Alghamdi , Abdulaziz Alharbi , Aalaa Saleh , Mansuor A. Alanazi

Abstract

Introduction: Chronic kidney disease (CKD) attributable to high fasting plasma glucose (HFPG) is rising globally, particularly in regions with rapidly increasing dysglycemia such as the Middle East and North Africa (MENA). We assessed long-term trends in HFPG-attributable CKD burden across 21 MENA countries from 1990 to 2023.

Methods: Using estimates from the Global Burden of Disease (GBD) 2023 study, we quantified deaths and disability-adjusted life years (DALYs) attributable to HFPG-related CKD at regional, national, age-group, and sex-specific levels. We derived age-standardized mortality rates (ASMRs) and age-standardized DALY rates (ASDRs) and evaluated temporal changes using joinpoint regression to identify significant shifts in burden across the study period.

Results: The absolute burden of HFPG-attributable CKD increased substantially across the region, with large rises in both deaths and DALYs. In contrast, ASMRs and ASDRs showed only modest changes, suggesting that population growth and ageing were major contributors to the rising burden. Older adults experienced the highest mortality and DALY rates, and men consistently exhibited greater burden at working ages. National patterns were heterogeneous, with some countries showing declining age-standardized rates while others demonstrated sustained increases. Joinpoint analysis revealed a transition from relative stability in the early 1990s to sustained increases after the late 2000s, with the most rapid acceleration occurring after 2019.

Conclusion: HFPG-attributable CKD is an escalating health challenge in the MENA region, driven by rising dysglycemia and demographic change, with substantial variation across countries. Strengthening early detection of dysglycemia and CKD, improving long-term glycemic and blood-pressure control, and expanding access to kidney-protective therapies are critical to mitigating the growing burden.

Keywords: Chronic kidney disease, high fasting plasma glucose, diabetes, MENA, Global Burden of Disease, DALYs.