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Kidney Disease Awareness Among U.S. Adults with CKD Stages 3-4

Kidney Disease Awareness Among U.S. Adults with CKD Stages 3-4

Among the 2017–March 2020 NHANES adult participants with chronic kidney disease (CKD) stages 3–4, 20.2% were aware of having CKD. This percentage is higher than in 2001–2004 (11.9%). For 2017–March 2020, the highest levels of awareness are observed among younger participants (30–49 years, 35.9%), non-Hispanic Black people (30.3%), males (23.9%), and adults with diabetes (28.4%) or hypertension (22.3%).

Data Source: NHANES

To view the awareness of CKD stages 3–4 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 3–4. Stage 5 was excluded from this analysis due to small numbers. 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

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 ≥ 18 years, pregnant women excluded.

Years Included

2001–March 2020.


Adults aged ≥ 18 years with CKD stages 3–4 who reported being told they have "weak or failing kidneys."


Adults aged ≥ 18 years with CKD stages 3–4 by serum creatinine measurements.

Definition of CKD and CKD Stage

CKD stages 3–4 are defined by estimated glomerular filtration rate (eGFR). Stage 3: eGFR 30–59 ml/min/1.73 m²; Stage 4: eGFR 15–29 ml/min/1.73 m²; Stage 5 excluded.

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 Black).

κ = 0.7 if female and 0.9 if male
α = -0.329 if female and -0.411 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 diabetes pills, 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 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.

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.