Approximately 1 in 7 adults in the United States has chronic kidney disease (CKD) stages 1–5. The overall crude prevalence of CKD was 13.9% during 2017–March 2020 and 12.9% during 2001–2004. CKD stages showed little change over time. Age-standardized prevalence trends moved in the opposite direction as compared to crude trends.
Data includes CKD stages 1–5. Estimates were standardized to the 2010 U.S. Census population for adults.
*Crude and age-standardized estimates for CKD stage 5 from 2001–2004 were suppressed due to small sample sizes (N ≤ 11).
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.
Prevalence of CKD stages in U.S. adults.
National Health and Nutrition Examination Survey (NHANES).
Noninstitutionalized U.S. adults aged ≥ 18 years, pregnant women excluded.
2001–March 2020.
U.S. adults aged ≥ 18 years with CKD stages 1–5.
U.S. adults aged ≥ 18 years with serum creatinine and urine albumin and creatinine measurements.
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). Stage 1: eGFR ≥90 ml/min/1.73 m² and albuminuria; stage 2: eGFR 60–89 ml/min/1.73 m² and albuminuria; stage 3a: eGFR 45–59 ml/min/1.73 m²; stage 3b: eGFR 30–44 ml/min/1.73 m²; stage 4: 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.
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
UACR was calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.
Serum creatinine values used for eGFR calculation were standardized against isotope dilution mass spectrometry (IDMS).
Measured in random urine collection by fluorescent immunoassay.
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%.
Albuminuria and kidney function were assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence.
Appropriate NHANES survey weights were 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.
