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Indicator Details: Reduce the Proportion of U.S. Adults with Chronic Kidney Disease
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From 2017 to March 2020, prevalence of CKD in the U.S. was 14.9%. There was no clear increasing or decreasing pattern in the unadjusted prevalence of CKD stages 1-4 over time.

Chart Explanation: 

For the period 2017- March 2020, the unadjusted prevalence of CKD stages 1-4 was approximately 14.9%. This is similar to the unadjusted prevalence for the period 2013-2016, which was approximately 14.8%.

The NHANES (National Health and Nutrition Examination Survey) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents. The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here, we examined data from the 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-March 2020 NHANES. eGFR was calculated according using the CKD-EPI equation for calibrated creatinine. Serum creatinine was calibrated for 1999-2000 and 2005-2006 participants; no correction was required for calibrated serum creatinine in participants in the 2001-2002, 2003-2004, 2007-2008, 2009-2010, and 2011-2012 surveys (Selvin et al., 2007). Albuminuria was defined by urinary albumin-to-creatinine ratios of 30-299 mg/g (microalbuminuria) and >300 mg/g (macroalbuminuria); pregnant women were excluded. For comparisons across the 18-year period 1999-2016, albuminuria was corrected in 1999-2006 to account for differences in the instrumentation and method for urine creatinine starting in 2007. Prevalence of CKD is likely overestimated due to single measurements of albuminuria and kidney function since chronic disease is defined as having albuminuria or reduced kidney function for ≥3 months.

Description of Measure

Prevalence of CKD stage 1-4

Data Source



Type of Data Source


Data Set


Health Care System Data


Regional or National?



Demographic Group

Noninstitutionalized U.S. residents aged 18+ years


Participants with CKD



Participants with serum creatinine and urine protein measurements

Definition of CKD

Stage 1, eGFR ≥ 90 ml/min/1.73 m² and presence of single albuminuria; Stage 2, eGFR 60-89 ml/min/1.73 m² and presence of single albuminuria; Stage 3, eGFR 30-59 ml/min/1.73 m²; Stage 4, 15-29 ml/min/1.73 m²; Stage 5, excluded

Glomerular filtration rate


Estimated using CKD-EPI equation for calibrated creatinine: eGFR=141 x [min(calibrated serum creatinine in mg/dL) /κ, 1)]α x [max(calibrated serum creatinine in mg/dL/κ, 1)]κ  x 0.993age x (1.018 if female) x (1.159 if NH Black)
κ = 0.7 if female, and 0.9 if male
α = -0.329 if female, and -0.411 if male



Urinary albumin-to-creatinine ratios of 30-299 mg/g (microalbuminuria) and >300 mg/g (macroalbuminuria); pregnant/menstruating women excluded

Primary Data Source Indicator

lbxscr: Serum creatinine

Primary Indicator Method of Measurement


Limitations of Indicator

Albuminuria and kidney function can only be assessed from a one-time cross-sectional measurement, leading to overestimation of prevalence; second measures of albuminuria are available for only 2009-2010 and were first-morning rather than spot urine samples; no second measures of creatinine

Analytic Considerations

Appropriate NHANES survey weights must be used for all analyses;

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd