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Trends in Kidney Disease Awareness among U.S. Adults with CKD Stages 3–5

Trends in Kidney Disease Awareness among U.S. Adults with CKD Stages 3–5

Among adults with chronic kidney disease (CKD) stages 3–5, the crude prevalence of being aware of having CKD was 24.8% during 2017–March 2020 as compared to 14.6% during 2001–2004. During 2017–March 2020, CKD awareness tended to be higher among non-Hispanic Black adults (26.3%), men (31.0%), those aged < 60 years (40.6%), adults with diabetes (32.2%), and/or with hypertension (25.9%) than their counterparts. CKD awareness tended to be highest among those with more advanced disease. Over 65% of patients with CKD stage 5 were aware of their disease in all years.

Data Source: NHANES

To view the awareness of CKD stages 3–5 by risk categories, select from the drop-down menu below. Risk categories include Overall, Age, Sex, Race/Ethnicity, Diabetes, Hypertension, and CKD Stage.

Aware of CKD (%), Overall

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Data includes CKD stages 3–5. “No Hypertension” was removed from this indicator due to a large standard error stemming from a small sample size. 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.

Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.

Description of Measure

Awareness of CKD among adults with CKD diagnosed by laboratory testing.

Data Set

National Health and Nutrition Examination Survey (NHANES).


Noninstitutionalized U.S. adults aged ≥ 20 years, pregnant women excluded.

Years Included

2001–March 2020.


Adults aged ≥ 20 years with CKD stages 3–5 who reported being told they have "weak or failing kidneys."


Adults aged ≥ 20 years with CKD stages 3–5 by serum creatinine measurements.

Definition of CKD Stages 3–5

CKD stages 3–5 are defined by estimated glomerular filtration rate (eGFR). Stage 3a: eGFR 45–59 ml/min/1.73 m²; stage 3b: eGFR 30–44 ml/min/1.73 m²; stage 4: eGFR 15–29 ml/min/1.73 m²; stage 5: eGFR <15 ml/min/1.73 m². Estimates are based on single estimates of eGFR and UACR.

Estimated glomerular filtration rate (eGFR)

Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20 x 0.9938**age x (1.012 if female).

κ = 0.7 if female and 0.9 if male
α = -0.241 if female and -0.302 if male
** = raise to the power

Serum Creatinine

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


Diabetes is defined by self-report of diabetes, taking insulin or oral anti-diabetes medications, or HbA1c ≥ 6.5%.


Hypertension is defined by self-report of hypertension, taking hypertension medications, or average systolic blood pressure greater than 140 mmHg (130 mmHg for CKD and diabetes) and diastolic blood pressure greater than 90 mmHg (80 mmHg for CKD and diabetes).

Limitations of Indicator

Kidney function is assessed from one-time cross-sectional measurement of serum creatinine. 

Analytical Considerations

Appropriate NHANES survey weights are used for all analyses; if the 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.