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Peer-reviewedCC BY-NC-NDBMC public health

Geographical disparities and temporal trends of end stage kidney disease incidence: a systematic review.

  • Lijalem M Tesfaw1,2
  • Yohani Dalugoda3
  • Mark K Tiong4,5
  • Nicholas J Osborne3,6,7
  • Gail M Williams8
  • Darsy Darssan3
8 affiliations
  1. 1School of Public Health, The University of Queensland, Brisbane, QLD, Australia. [email protected].
  2. 2Department of Statistics, Bahir Dar University, Bahir Dar, Amhara, Ethiopia. [email protected].
  3. 3School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
  4. 4Department of Nephrology, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
  5. 5Department of Medicine (RMH), University of Melbourne, Melbourne, VIC, Australia.
  6. 6School of Population Health, University of New South Wales, Sydney, NSW, Australia.
  7. 7European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
  8. 8Faculty of Health Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.
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Abstract

Background

While individual studies address the geographical and temporal variations contributing to end-stage kidney disease (ESKD) incidence, there is a notable lack of comprehensive research consolidating these findings.Methods

This study systematically reviewed and analyzed original articles reporting the incidence of ESKD across different geographical locations and time over two decades worldwide. The study focused on individuals with ESKD, aged 18 and older, regardless of whether they received kidney replacement therapy. Original studies published between 01 Jan 2003 and 23 March 2026 focusing on ESKD incidence and reporting geographical variations and/or temporal trends were included. Literature screening and data extraction were performed using Covidence. Geographical variations in ESKD incidence were assessed across countries, major sub-divisions, and small areas, while temporal trends were evaluated both annually and seasonally.Results

Among forty-one papers reviewed, 18 (43.9%) reported geographical variation, 17 (41.5%) reported temporal trends, and 6(14.6%) reported both. Of those examining geographical variations, 16.7% assessed ESKD incidence across countries, 33.3% across major sub-divisions, and 50.0% across small areas. ESKD incidence varies widely across regions, ranging from 100 per million population in Nepal to over 450 in Taiwan, with higher rates in high-income settings and notable within-country disparities in areas such as the southern United States, southern Taiwan, and parts of Japan. Incidence has increased over time, though some regions remain stable, with higher rates observed in winter than summer.Conclusion

Geographical variation in ESKD incidence was observed across countries, regions, and small areas, with notable increases over time. Factors impacting geographical variations include angiotensin converting enzyme inhibitor use, income, erythropoietin use, obesity, and paraquat exposure, while race, country of residence, diabetes type, hypertension, cardiovascular disease, and calendar year affect temporal variations. Both age and gender contribute to geographical and temporal variations.

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Cite

BibTeXRIS
BibTeX
@article{tesfaw2026geographical,
  title = {{Geographical disparities and temporal trends of end stage kidney disease incidence: a systematic review.}},
  author = {Lijalem M Tesfaw and Yohani Dalugoda and Mark K Tiong and Nicholas J Osborne and Gail M Williams and Darsy Darssan},
  journal = {BMC public health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12889-026-28365-2},
  url = {https://europepmc.org/article/MED/43009887},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Geographical disparities and temporal trends of end stage kidney disease incidence: a systematic review.
AU  - Lijalem M Tesfaw
AU  - Yohani Dalugoda
AU  - Mark K Tiong
AU  - Nicholas J Osborne
AU  - Gail M Williams
AU  - Darsy Darssan
PY  - 2026
DA  - 2026/07/28
JO  - BMC public health
DO  - 10.1186/s12889-026-28365-2
UR  - https://europepmc.org/article/MED/43009887
AB  - Background  While individual studies address the geographical and temporal variations contributing to end-stage kidney disease (ESKD) incidence, there is a notable lack of comprehensive research consolidating these findings.Methods  This study systematically reviewed and analyzed original articles reporting the incidence of ESKD across different geographical locations and time over two decades worldwide. The study focused on individuals with ESKD, aged 18 and older, regardless of whether they received kidney replacement therapy. Original studies published between 01 Jan 2003 and 23 March 2026 focusing on ESKD incidence and reporting geographical variations and/or temporal trends were included. Literature screening and data extraction were performed using Covidence. Geographical variations in ESKD incidence were assessed across countries, major sub-divisions, and small areas, while temporal trends were evaluated both annually and seasonally.Results  Among forty-one papers reviewed, 18 (43.9%) reported geographical variation, 17 (41.5%) reported temporal trends, and 6(14.6%) reported both. Of those examining geographical variations, 16.7% assessed ESKD incidence across countries, 33.3% across major sub-divisions, and 50.0% across small areas. ESKD incidence varies widely across regions, ranging from 100 per million population in Nepal to over 450 in Taiwan, with higher rates in high-income settings and notable within-country disparities in areas such as the southern United States, southern Taiwan, and parts of Japan. Incidence has increased over time, though some regions remain stable, with higher rates observed in winter than summer.Conclusion  Geographical variation in ESKD incidence was observed across countries, regions, and small areas, with notable increases over time. Factors impacting geographical variations include angiotensin converting enzyme inhibitor use, income, erythropoietin use, obesity, and paraquat exposure, while race, country of residence, diabetes type, hypertension, cardiovascular disease, and calendar year affect temporal variations. Both age and gender contribute to geographical and temporal variations.
SN  - 1471-2458
ER  -