Disease Burden of Hypertensive Nephropathy Attributable to High Sodium Diet in China，Japan，and the United States During 1990-2021 and Its Predictive Analysis

Lanxi FANG; Guanlin LIU; Yuhang YANG; Delong ZHAO; Wanchen DAI; Qiong MENG

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Lanxi FANG, Guanlin LIU, Yuhang YANG, Delong ZHAO, Wanchen DAI, Qiong MENG. Disease Burden of Hypertensive Nephropathy Attributable to High Sodium Diet in China，Japan，and the United States During 1990-2021 and Its Predictive Analysis[J]. Journal of Kunming Medical University.

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Disease Burden of Hypertensive Nephropathy Attributable to High Sodium Diet in China，Japan，and the United States During 1990-2021 and Its Predictive Analysis

Lanxi FANG^{1, 2},
Guanlin LIU^{1, 2},
Yuhang YANG²,
Delong ZHAO²,
Wanchen DAI²,
Qiong MENG^{1
,
,}

1.
School of Public Health，Kunming Medical University，Kunming Yunnan 650500
2.
The First Clinical School of Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2025-11-05

Abstract

Abstract

Objective To analyze the disease burden and trends of hypertensive nephropathy attributed to high sodium diet in China, Japan, and the United States from 1990 to 2021, and to project trends from 2022 to 2036. Methods Data were extracted from the 2021 Global Burden of Disease （GBD 2021） database, including age-standardized mortality rates （ASMR） and age-standardized disability-adjusted life year rates （ASDALYR） for hypertensive nephropathy attributed to high sodium diet. Estimated annual percentage change （EAPC） and Joinpoint regression models were used to analyze historical trends, while the Bayesian age-period-cohort （BAPC） model was employed to project future disease burden. Results Globally, ASMR and ASDALYR for hypertensive nephropathy attributed to high sodium diet showed significant upward trends, with EAPC of 0.58 （95%CI: 0.53～0.62） and 0.32 （95%CI: 0.2～0.37）, respectively. Stratified analysis revealed statistically significant differences in ASDALYR among males （EAPC = 0.44, 95%CI: 0.39～0.48）. Among the three countries, China bore the heaviest disease burden, though with a declining trend （EAPC: -1.35 [95%CI: -1.43 to -1.27] for ASMR and -1.26 [95%CI: -1.36 to -1.16] for ASDALYR）, with more pronounced decline in females. Japan had the lightest disease burden with the most significant declining trends （EAPC: -1.72 [95%CI: -2.01 to -1.42] for ASMR and -2.02 [95%CI: -2.26 to -1.79] for ASDALYR）, particularly among females. The United States showed upward trends （EAPC: 4.68 [95%CI: 4.40～4.97] for ASMR and 4.72 [95%CI: 4.38～5.50] for ASDALYR）, with males showing significantly higher increases than females. Joinpoint analysis revealed that ASDALYR declined after 2004 globally in females and in both sexes in China, while Japan demonstrated declining trends after 1995. BAPC projections for 2022-2036 indicated that ASDALYR in both males and females in China and Japan would show steady decreases, with rates declining from 24.65/100,000 and 14.06/100,000 to 23.38/100,000 and 13.46/100,000 in Chinese males and females, respectively, and from 9.47/100,000 and 3.03/100,000 to 8.56/100,000 and 2.55/100,000 in Japanese males and females, respectively. The United States showed sex-specific divergence, with male ASDALYR slightly declining from 22.53/100,000 to 22.10/100,000, while female rates continued to increase from 8.34/100,000 to 9.34/100,000. Conclusion The global disease burden of hypertensive nephropathy attributed to high sodium diet remains inadequately controlled with significant national and gender disparities. Strict sodium intake control represents a key potential intervention target for preventing hypertensive nephropathy. Countries should adopt effective strategies from Japan's experience and develop precision-based prevention and control measures.
- Hypertensive kidney disease,
- Sodium dietary,
- Global burden of disease,
- Disability-adjusted life year,
- Predictive analysis

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References(31)

References

[1]	Sun D, Wang J, Shao W, et al. Pathogenesis and damage targets of hypertensive kidney injury[J]. J Transl Int Med, 2020, 8(4): 205-209. doi: 10.2478/jtim-2020-0033
[2]	Zhang C, Fang X, Zhang H, et al. Genetic susceptibility of hypertension-induced kidney disease[J]. Physiol Rep, 2021, 9(1): e14688.
[3]	He Y, Tang W, Chen J, et al. Global burden of chronic kidney disease due to hypertension (1990-2021): A systematic analysis of epidemiological trends, risk factors, and projections to 2036 from the GBD 2021 study[J]. BMC Nephrol, 2025, 26(1): 448.
[4]	Ameer O Z. Hypertension in chronic kidney disease: What lies behind the scene[J]. Front Pharmacol, 2022, 13: 949260. doi: 10.3389/fphar.2022.949260
[5]	吴树法, 曹汝岱, 黄文龙, 等. 1990年—2021年中国和全球高血压肾病疾病负担及预测研究[J]. 华西医学, 2025, 40(7): 1084-1090. doi: 10.7507/1002-0179.202411184
[6]	Murray C J L. The global burden of disease study at 30 years[J]. Nat Med, 2022, 28(10): 2019-2026. doi: 10.1038/s41591-022-01990-1
[7]	Ahmad O B, Boschi-Pinto C, Lopez A D, et al. Age standardization of rates: A new WHO standard[R]. GPE Discuss Pap Ser, 2001, 31: 1-14.
[8]	Yang X, Zhang T, Zhang X, et al. Global burden of lung cancer attributable to ambient fine particulate matter pollution in 204 countries and territories, 1990-2019[J]. Environ Res, 2022, 204(Pt A): 112023.
[9]	Yang X, Chen H, Zhang T, et al. Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: A systematic analysis from the global burden of disease study 2019[J]. Aging, 2021, 13(15): 19614-19642. doi: 10.18632/aging.203374
[10]	陈飞, 王悠清. 1990—2019年中国食管癌疾病负担及其变化趋势分析[J]. 中国肿瘤, 2021, 30(6): 401-407.
[11]	Hu W, Fang L, Zhang H, et al. Global disease burden of COPD from 1990 to 2019 and prediction of future disease burden trend in China[J]. Public Health, 2022, 208: 89-97. doi: 10.1016/j.puhe.2022.04.015
[12]	Parksook W W, Williams G H. Challenges and approach to identifying individuals with salt sensitivity of blood pressure[J]. Am J Nephrol, 2022, 53(11-12): 847-855. doi: 10.1159/000529057
[13]	Jeong S, Hunter S D, Cook M D, et al. Salty subjects: Unpacking racial differences in salt-sensitive hypertension[J]. Curr Hypertens Rep, 2024, 26(1): 43-58. doi: 10.1007/s11906-023-01275-z
[14]	曹镌文. 盐敏感性高血压钠代谢相关基因的研究进展[J]. 临床与病理杂志, 2020, 40(10): 2721-2726. doi: 10.3978/j.issn.2095-6959.2020.10.037
[15]	Romberger N T, Stock J M, Patik J C, et al. Inverse salt sensitivity in normotensive adults: Role of demographic factors[J]. J Hypertens, 2023, 41(6): 934-940. doi: 10.1097/HJH.0000000000003413
[16]	Ikeda N, Yamashita H, Hattori J, et al. Reduction of cardiovascular events and related healthcare expenditures through achieving population-level targets of dietary salt intake in Japan: A simulation model based on the national health and nutrition survey[J]. Nutrients, 2022, 14(17): 3606. doi: 10.3390/nu14173606
[17]	程显扬. 基于政策工具的《健康中国行动(2019—2030年)》文本分析[J]. 东北大学学报(社会科学版), 2020, 22(5): 65-72. doi: 10.15936/j.cnki.1008-3758.2020.05.009
[18]	国家卫生健康委员会官网. 体重管理指导原则(2024年版)摘登[J]. 新医学, 2025, 56(6): 627-628. doi: 10.12464/j.issn.0253-9802.2025-0165
[19]	马丽媛, 王增武, 樊静, 等. 《中国心血管健康与疾病报告2021》要点解读[J]. 中国全科医学, 2022, 25(27): 3331-3346. doi: 10.12114/j.issn.1007-9572.2022.0506
[20]	刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告2024》要点解读[J]. 实用医学杂志, 2025, 41(14): 2111-2131. doi: 10.3969/j.issn.1006-5725.2025.14.001
[21]	Ahuja J K C, Li Y, Haytowitz D B, et al. Assessing changes in sodium content of selected popular commercially processed and restaurant foods: Results from the USDA: CDC sentinel foods surveillance program[J]. Nutrients, 2019, 11(8): 1754. doi: 10.3390/nu11081754
[22]	Niu K, Momma H, Kobayashi Y, et al. The traditional Japanese dietary pattern and longitudinal changes in cardiovascular disease risk factors in apparently healthy Japanese adults[J]. Eur J Nutr, 2016, 55(1): 267-279. doi: 10.1007/s00394-015-0844-y
[23]	Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2004)[J]. Hypertens Res, 2006, 29 Suppl: S1-S105.
[24]	Gohar E Y, De Miguel C, Obi I E, et al. Acclimation to a high-salt diet is sex dependent[J]. J Am Heart Assoc, 2022, 11(5): e020450.
[25]	Visniauskas B, Kilanowski-Doroh I, Ogola B O, et al. Estrogen-mediated mechanisms in hypertension and other cardiovascular diseases[J]. J Hum Hypertens, 2023, 37(8): 609-618.
[26]	Tao Y, Young-Stubbs C, Yazdizadeh Shotorbani P, et al. Sex and strain differences in renal hemodynamics in mice[J]. Physiol Rep, 2023, 11(6): e15644. doi: 10.14814/phy2.15644
[27]	Oloyo A K, Imaga N O A, Fatope Y, et al. Sex differences in cardiac and renal responses to a high salt diet in Sprague-Dawley rats[J]. Heliyon, 2019, 5(5): e01665. doi: 10.1016/j.heliyon.2019.e01665
[28]	Tahaei E, Coleman R, Saritas T, et al. Distal convoluted tubule sexual dimorphism revealed by advanced 3D imaging[J]. Am J Physiol Renal Physiol, 2020, 319(5): F754-F764. doi: 10.1152/ajprenal.00441.2020
[29]	Administration for community living. 2023 profile of older Americans[R]. U. S. Department of Health and Human Services, 2024, 5. https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf
[30]	Robinson K. Trends in health status and health care use among older women[R]. U. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. 2007, 3. http://www.cdc.gov/nchs/data/ahcd/agingtrends/07olderwomen.pdf
[31]	Xiang D, Liu Y, Zhou S, et al. Protective effects of estrogen on cardiovascular disease mediated by oxidative stress[J]. Oxid Med Cell Longev, 2021, 2021: 5523516. doi: 10.1155/2021/5523516

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