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Prevalence of Self-Reported Serious Difficulties Among U.S. Adults Aged ≥ 65 years With and Without CKD

Prevalence of Self-Reported Serious Difficulties Among U.S. Adults Aged ≥ 65 years With and Without CKD

A higher prevalence of serious difficulty hearing, seeing, concentrating, walking, dressing, and running errands is reported by adults aged ≥ 65 years with chronic kidney disease (CKD) than without CKD. The most prevalent difficulty reported is with walking.

Data Source: NHANES


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Limited to adults aged 65 years and older. Data are not adjusted.

NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center.

Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.

Description of Measure

Prevalence of disability with and without CKD in the U.S. population ≥ 65 years of age.

Data Set

National Health and Nutrition Examination Survey (NHANES).


Noninstitutionalized U.S. adults aged ≥ 65 years.

Years Included



Adults aged ≥ 65 years who reported having a difficulty.


Adults aged ≥ 65 years who completed the difficulty survey and had measurements of serum creatinine and urine albumin.

Definition of CKD and CKD Stage

CKD is defined by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Stage 1: eGFR ≥ 90 ml/min/1.73 m² and albuminuria; Stage 2: eGFR 60–89 ml/min/1.73 m² and albuminuria; Stage 3: eGFR 30–59 ml/min/1.73 m²; Stage 4: 15–29 ml/min/1.73 m²; Stage 5: excluded. Estimates are based on single estimates of eGFR and UACR.

Estimated glomerular filtration rate (eGFR)

Based on CKD-EPI equation for calibrated creatinine: eGFR=141 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20  x 0.993**age x (1.018 if female) x (1.159 if a Black person).

κ = 0.7 if female and 0.9 if male
α = -0.329 if female and -0.411 if male
** = raise to the power


UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.

Serum Creatinine

Serum creatinine values used for eGFR calculation are standardized against isotope dilution mass spectrometry (IDMS).

Urine Albumin

Measured in random urine collection by fluorescent immunoassay.

Limitations of Indicator

Difficulties are self-reported. Albuminuria and kidney function are assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence. 

Analytical Considerations

Appropriate NHANES survey weights are used for all analyses; if relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.

References and Sources:
  • U.S. Department of Health and Human Services. U.S. Department of Health and Human Services Implementation Guidance on Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability status. 2011.

eGFR Formula Disclaimer
At the time of the last data update in summer 2022, the race-free eGFR formula was newly recommended and impact on health outcomes is underway. To avoid inconsistent results caused by different formulae, stakeholders continued using the eGFR formula with race during this transition. Since then, comparisons have been made. The estimates for the current website launch are still based on analyses using the eGFR formula with race, however plan is to use race-free eGFR formula for the next data update and upcoming website launch in fall 2023.