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Indicator Details: Prevalence of CKD in the U.S. Population 1999–2004 vs. 2005–2010 vs. 2020 Targeta,b
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  • NHANES

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Footnotes:
a Health insurance status is limited to individuals younger than 65 years of age to exclude potential Medicare patients.

b

Educational attainment data was collected only for subjects 25 years and over.






The baseline CKD prevalence estimate is 14.9%, while the current estimate is similar 14.8%. A downward trend is observed for people younger than 75 years of age and an increase for those aged 75 years and older. People with disabilities, Veterans or obese had overall higher CKD prevalence than those without disability, non-Veterans, or not obese.

Chart Explanation: 

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 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016 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.

FieldData
Description of MeasurePrevalence of CKD stage 1-4
Data SourceNCHS
Type of Data SourcePublic
Data SetNHANES
Health Care System DataNo
Regional or National?National
Demographic GroupNon-institutionalized U.S. residents aged 20+ years
NumeratorNumber of adults 18 years or older with chronic kidney disease (CKD) stages 1-4. CKD stages 1-4 defined as urinary albumin/creatinine ratio (ACR) ≥30 mg/g (single measurement) or estimated glomerular filtration rate (eGFR) between 15 and 59 ml/min/1.73 m²
DenominatorNumber of adults 18 years or older with measured urinary albumin/creatinine ratio (ACR) and information to compute estimated glomerular filtration rate (eGFR)
Definition of CKDStage 1, eGFR ≥ 90 ml/min/1.73 m² and estimated persistent albuminuria; Stage 2, eGFR 60-89 ml/min/1.73 m² and estimated persistent 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)]-1.209 x 0.993age x (1.018 if female) x (1.159 if non-Hispanic Black)
κ = 0.7 if female, and 0.9 if male
α = -0.329 if female, and -0.411 if male

ProteinuriaUrinary albumin-to-creatinine ratios of 30-299 mg/g (microalbuminuria) and >300 mg/g (macroalbuminuria); pregnant/menstruating women excluded
Primary Data Source Indicatorlbxscr: Serum creatinine
Primary Indicator Method of MeasurementExamination/Laboratory
Secondary (1) Variableridageyr: Age in years
Secondary (1) Indicator Method of MeasurementQuestionnaire (interviewer-administered)
Secondary (2) Variableridgendr: Gender
Secondary (2) Indicator Method of MeasurementQuestionnaire (interviewer-administered)
Secondary (3) VariableNo
Secondary (3) Indicator Method of Measurementridreth1: Race/ethnicity
Secondary (3) from Medical Record?Questionnaire (interviewer-administered)
Secondary (4) Data Source Indicatorurxuma: Urine albumin
Secondary (4) Indicator Method of MeasurementExamination/lab
Secondary (5) Data Source Indicatorurxucr: Urine creatinine
Secondary (5) Indicator Method of MeasurementExamination/lab
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available1999–2010
Pending Data2011-2016
Additional Data Items of InterestStage of CKD, year, other stratification variables of interest (diabetes by self-report, hypertension by self-report)
Limitations of IndicatorAlbuminuria 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 ConsiderationsAppropriate NHANES survey weights must be used for all analyses; creatinine measurements must be calibrated for NHANES III, 1999-2000 and 2005-2006; many variable names differ across surveys; if SE 30% or more of estimate, must report as “low precision”

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