Abstract
<title>Abstract</title> <p>Background Chronic kidney disease (CKD) is a major non-communicable disease and an increasing global public health challenge. High sodium intake is an important dietary risk factor for CKD and is closely associated with major CKD subtypes, particularly hypertension-related CKD (CKD-HTN) and type 2 diabetes-related CKD (CKD-T2DM). With rapid global population ageing, the burden of CKD among older adults has risen substantially; however, the specific contribution of high sodium intake to this burden remains insufficiently characterized. Methods Using data from the Global Burden of Disease (GBD) 2021 study, we assessed the burden of CKD attributable to high sodium intake among adults aged ≥ 60 years from 1990 to 2021. Age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) were used as the primary indicators. Temporal trends were evaluated using estimated annual percentage change (EAPC), and future burden from 2022 to 2050 was projected using a Bayesian age-period-cohort (BAPC) model. Analyses were conducted across 21 GBD regions and 204 countries, with further stratification by sociodemographic index (SDI), sex, age, and CKD subtype. Results From 1990 to 2021, CKD deaths and DALYs attributable to high sodium intake among older adults increased by 186.33% and 156.80%, respectively, accounting for 85.73% and 72.19% of the total burden across all age groups. Middle-SDI regions had the highest ASMR and ASDR, while high-income North America showed the fastest increases (EAPC for ASMR 3.76%; ASDR 3.44%). In contrast, high-income Asia Pacific showed marked declines (ASMR − 2.60%; ASDR − 2.69%). Males experienced greater annual increases in ASMR and ASDR than females. Most regions displayed a J-shaped age pattern, with burden rising more sharply after age 70. CKD-HTN was the predominant sodium-related subtype and largely mirrored the overall CKD pattern, whereas other subtypes contributed relatively less. Projections suggest that the burden will continue to rise through 2050, particularly among males. Conclusions High sodium intake remains an important contributor to CKD burden in older adults, with substantial variation across regions, SDI levels, sex, and subtype. Targeted prevention strategies, including salt reduction, dietary improvement, and early screening in high-risk populations, are needed to reduce the future CKD burden.</p>