The overall prevalence of eGFR <60 ml/min/1.73m2 in the U.S. among the adolescent population has decreased in the last decade. From 2017 to March 2020, the prevalence was approximately 0.08%, compared to 0.75% in 2009 to 2012.
The prevalence of eGFR <60 ml/min/1.73m2 among adolescents aged 12-17 years old in the United States from 2017-March 2020 was approximately 0.08%. This is a decrease from previous years. eGFR <60 is calculated using the U25 equation. The prevalence went up to 0.75% in 2009 to 2012 and dropped back down to 0.19% in 2013 to 2016.
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.
Prevalence of CKD among Adolescents using eGFR <60.
Noninstitutionalized U.S. residents aged 12-17 years old.
Participants with eGFR <60.
Participants with eGFR measures.
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
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
Appropriate NHANES survey weights must be used for all analyses
CKD can be difficult to diagnose in adolescents.