What is the cause of the majority of cases of chronic kidney disease in developed countries?

The majority of cases of chronic kidney disease (CKD) in developed countries are primarily attributed to diabetes mellitus. This is largely due to the increased prevalence of type 2 diabetes, which is associated with various abnormalities that can lead to kidney damage. The effects of hyperglycemia on the kidney are multifaceted, including increased glomerular pressure and hyperfiltration that eventually lead to diabetic nephropathy, the most common cause of CKD in the Western world.

Diabetes mellitus causes renal impairment through mechanisms such as the accumulation of advanced glycation end products and the activation of various biochemical pathways that lead to inflammation and fibrosis within the kidney. Over time, as diabetic nephropathy progresses, it results in a gradual loss of kidney function, often leading to the need for dialysis or transplant.

Hypertension also plays a significant role in kidney disease and is, in fact, a common comorbidity for individuals with diabetes. However, while it is a critical factor in the progression of CKD, it typically acts as a complication rather than a primary cause.

In contrast, glomerulonephritis, while it can lead to CKD, represents a smaller proportion of patients with chronic kidney disease in developed countries. Similarly, renal artery stenosis