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Trends in Prevalence of CKD among U.S. Adults

Trends in Prevalence of CKD among U.S. Adults

Crude prevalence of chronic kidney disease (CKD) among adults aged ≥ 18 years was 13.9% during 2017–March 2020 compared to 12.9% during 2001–2004. Prevalence was higher in adults aged ≥ 70 years, women, non-Hispanic Black adults, and adults with diabetes or hypertension. Crude prevalence of CKD was 38.0% among adults aged ≥ 70 years during 2017–March 2020 and 47.1% during 2001–2004. For both crude and age-standardized prevalence, although not significant, prevalence of CKD among adults with diabetes showed a downward trend until 2013–2016, after which it increased during 2017–March 2020 while prevalence remained relatively constant among adults with hypertension.

Data Source: NHANES

To view the prevalence of CKD by risk categories, select from the drop-down menu below. Risk categories include: Overall, Age Category, Sex, Race/Ethnicity, Diabetes, and Hypertension.


CKD (%), by Race/Ethnicity

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Data includes CKD stages 1–5. Estimates were standardized to the 2010 U.S. Census population for adults.

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.

FieldData
Description of Measure

Prevalence of CKD in the U.S. population.

Data Set

National Health and Nutrition Examination Survey (NHANES).

Population

Noninstitutionalized U.S. adults aged ≥ 18 years, pregnant women excluded.

Years Included

2001–March 2020.

Numerator

Adults aged ≥ 18 years with CKD.

Denominator

Adults aged ≥ 18 years with serum creatinine and urine albumin and creatinine measurements. When stratified by diabetes or hypertension, the denominator is U.S. adults aged ≥ 18 years with diabetes or hypertension with no missing values.

Definition of CKD

CKD is defined by an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥30 mg/g). 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

Albuminuria

UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.

Serum Creatinine

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

Urine Albumin

Measured in random urine collection by fluorescent immunoassay.

Diabetes

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

Hypertension

Hypertension is defined by self-reported hypertension, treatment with 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).

Age Standardization

Age-standardized estimates were standardized to the 2010 U.S. Census population for adults. 18–39 years: 37.1%, 40–59 years: 38.1%, 60–69 years: 12.8%, and 70+ years: 12.0%.

Limitations of Indicator

Albuminuria and kidney function were assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence.

Analytical Considerations

Appropriate NHANES survey weights were used for all analyses; if relative standard error was greater than 30%, the estimates were not shown. Serum creatinine measurements were assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.


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