The global, regional, and national patterns of change in the burden of acute glomerulonephritis, 1990-2021: an analysis of the global burden of disease study 2021 and forecast to 2036.

Abstract

Background: To understand and prevent global trends of acute glomerulonephritis (AGN), we analyzed its burden from 1990 to 2021.

Methods: Using GBD 2021 data, we estimated the global burden of AGN by calculating age-standardized rates (ASR) of incidence (ASIR), prevalence (ASPR), mortality (ASMR), and DALYs (ASDR), along with corresponding counts, and assessed temporal trends using estimated annual percentage change (EAPC), decomposition analysis, frontier analysis, and ASR-based projections.

Results: From 1990 to 2021, the global burden of AGN declined overall, with the largest reduction observed in DALYs (-44.96%). ASR generally decreased but showed a slight rebound after 2010. Incidence peaked at ages 10-14 and 85-89 years. Substantial disparities were observed across SDI regions: ASR was higher in middle and high-middle SDI regions; although ASIR and ASPR were lower in low SDI regions, ASMR and ASDRs were relatively higher; notably, increases in ASMR and ASDRs were observed only in high SDI regions. Correlation analyses showed that ASMR and ASDRs were significantly negatively associated with SDI. Decomposition analysis indicated that epidemiological changes were the main driver of the global decline in AGN burden. Frontier analysis suggested that countries with middle SDI have the greatest potential for improvement in disease control. Projections indicate that by 2036, global ASIR and ASPR may slightly increase, whereas ASMR and ASDRs are expected to continue declining.

Conclusions: Overall, despite the marked global decline in AGN burden, substantial regional heterogeneity persists, underscoring the need for tailored public health strategies according to regional SDI levels.