Abstract
This study reports trends in acute glomerulonephritis (AGN) mortality in older adults (aged 65-94 years) and its association with age, period, and birth cohort across 204 countries and territories over the past 30 years, using data from the Global Burden of Disease (GBD) 2021 Study. An age-period-cohort model was used to estimate the overall annual percentage change in AGN mortality (net drift), annual percentage change for individuals aged 65-94 years (local drift), and longitudinal age-specific rates adjusted for period bias and period/cohort relative risks from 1992 to 2021. In 2021, there were 6213 AGN-related deaths globally (95% UI: 4460-7961). Between 1992 and 2021, the net drift for AGN mortality in high socio-demographic index (SDI) countries was 3.15% per year (95% CI 2.62-3.69), compared to - 1.18% per year in low SDI countries (95% CI - 2.01 to - 0.33). High-middle SDI countries had a decline of - 1.49% per year (95% CI - 1.80 to - 1.18), middle SDI countries - 1.52% per year (95% CI - 1.75 to - 1.28), and low-middle SDI countries - 1.78% per year (95% CI - 2.37 to - 1.20). Globally, high SDI countries showed an upward trend in AGN mortality, while others showed a downward trend. Despite the declining mortality in many regions, 15 high SDI countries, 5 high-middle SDI countries, 4 middle SDI countries, 5 low-middle SDI countries, and 3 low SDI countries showed poor or worsening outcomes in the most recent period and birth cohort. These findings suggest that AGN mortality trends are not related to a country's economic development, highlighting the need for high SDI countries to invest more in AGN-related healthcare.