WCN26-3811 Modelling the projected clinical and environmental burden of chronic kidney disease in Egypt and Morocco between 2025 and 2030
Mohamed Salah, Amir Maoujoud, Harrison Goldspink, Laura Webber, Camila Llanes-Kidder, Lindsay Nicholson, Nina Emnbleton, Paula Pohja-Hutchison, Clelia-Elsa Froguel, Nelson Otieno Ochieng, Qutaiba Al Manaseer, Karem Mohammed Salem
April 2026, Kidney International reports 11(4):104759, doi: 10.1016/j.ekir.2026.104759
Abstract
Introduction
The prevalence of chronic kidney disease (CKD) is estimated to be 15.8% in Africa. Across the continent, diagnosis and treatment rates are low, with most patients being diagnosed in the later stages of disease. This is due to some cases of CKD, particularly in the earlier stages, presenting asymptomatically. Consequently, CKD imposes a significant burden on health systems, particularly due to increased risk of cardiovascular (CV) complications, and kidney replacement therapy (KRT). The objective of this study was to project the clinical and environmental burden of CKD between 2025 and 2030 in Egypt and Morocco.
Methods
Virtual populations representative of Egypt and Morocco were generated between 2025 and 2030, using a microsimulation model. Individuals were assigned discrete characteristics such as age, sex, and CKD status, based on country-specific demographic and epidemiological data. Where country-specific data was unavailable, proxy data was used. Each year, modelled individuals progressed through CKD stages based on age-related estimated glomerular filtration rate decline rates and related comorbidities, to generate population-level projections of the clinical burden of CKD. Greenhouse gas (GHG) emissions associated with in-centre haemodialysis (HD) were estimated and scaled to per-patient healthcare resource utilisation estimates of CKD patients on HD. Hospitalisation-specific GHG emission estimates were also generated based on the average emissions produced daily on a general ward. These estimates were then scaled to produce population-level estimates in Egypt and Morocco.
Results
CKD prevalence and its clinical burden were projected to rise substantially in both countries. CKD prevalence increased from 4.8% to 6.1% in Egypt and from 4.1% to 4.7% in Morocco between 2025 and 2030, with only 6–7% of cases expected to be clinically diagnosed and recorded. Between 2025 and 2030, there were 6,762 incident cases of heart failure (HF), 14,027 incident cases of myocardial infarction (MI), and 5,515 incident cases of stroke in the diagnosed CKD population in Egypt. In Morocco, there were 4,665, 11,737, and 5,319 incident cases of HF, MI and stroke, respectively. By 2030, there were a projected total of 227,758 and 75,599 deaths among diagnosed CKD patients in Egypt and Morocco, respectively. The prevalence of in-centre HD was also projected to increase to 83,048 and 42,056 cases by 2030 in Egypt and Morocco, corresponding to the emission of 1,500 and 890 tonnes of GHG emissions, respectively. Over 6 years, there were 2.3 million and 4.9 million hospitalisation days, resulting in 59,000 and 149,000 tonnes in GHG emissions in Egypt and Morocco.
Conclusion
This study demonstrates the large future clinical and environmental burden of CKD in Egypt and Morocco within the current standard of care. The use of proxy data may limit the representativeness of our findings of the burden of CKD in these diverse populations. The high prevalence of CV complications, KRT, and hospitalisations underscore the need for earlier CKD detection and improved surveillance, such as the implementation of national and regional strategies for early screening and treatment, alongside integrated approaches for environmental sustainability to mitigate the projected clinical and environmental burden of CKD.