Indicator Details: Prevalence of the U.S. Population Reporting Disability by CKDa
Data Sources
 
Stratification and Year Choices:

  Source
  • NHANES

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Footnotes:
a Estimates for disability prevalence are age-adjusted.




In 2015–2016, age-adjusted prevalence of self-reported disability in U.S. adults aged 65+ years was greater in those with CKD stages 3 and 4 compared to those at stages 1 and 2; however, a higher percentage of elderly adults at CKD stages 1 and 2 self-reported disability in walking than compared to those at stages 3 and 4 (36% vs. 28%, repsectively). 
Chart Explanation: Among U.S. adults aged 65+ years in 2015–2016, the age-adjusted prevalence of self-reported disability remained higher in persons with CKD stages 3 and 4 when compared to those with stages 1 and 2 or with no CKD. Specifically, those at stages 3 and 4 had a higher percentage of people self-report disability in hearing, concentrating and doing errands alone (24.4%, 12.5%, and 17.3%) compared to those at stages 1 and 2 (23.3%, 9.9%, and 14.6%, respectively). However, those at stages 1 and 2 had a higher percentage of elderly adults self-report disability in walking than compared to those at stages 3 and 4 or no CKD (36.1% vs. 28.1% vs. 20.1%, respectively). In those with CKD stages 3 and 4, the most frequently reported disability was walking (28.1%), and the least dressing and bathing (10.7%).  

 
The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, cross-sectional survey that is currently conducted every two years by the Centers for Disease Control and Prevention's National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.

Although much information is available regarding disability among those with end-stage renal disease (ESRD) (United States Renal Disease System, 2017), little has been reported regarding the burden of disability among those with earlier-stage CKD. The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center. Here we examined data from the 2013–2014 and 2015–2016 NHANES. The six items used to define self-reported disability are viewed as the minimum standards for disability status by the U.S. Department of Health and Human Services. Self-reported disabilities were defined by answers of “yes” to questions such as “Are you deaf or do you have serious difficulty hearing?”
FieldData
Description of MeasurePrevalence of disability among those with CKD in the general population
Data SourceNCHS/CDC
Type of Data SourcePublic
Data SetNHANES
Health Care System DataNo
Regional or National?National
Demographic GroupNoninstitutionalized U.S. residents aged 65+ years
NumeratorNonpregnant participants with completed disability surveys and with CKD information who reported having disabilities
DenominatorNonpregnant participants with completed disability surveys and with CKD information
Definition of CKDPresence of single albuminuria or estimated glomerular filtration rate (eGFR) 15-59 ml/min/1.73 m2
Glomerular filtration rateEstimated 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 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 IndicatordlqXXX variables
Primary Indicator Method of MeasurementQuestionnaire (computer-assisted); disability survey given to participants ages 1+ (proxy provided for ages 1-15); indiciator sample covers ages 65+
Secondary (1) Variablelbxscr: Serum creatinine measurements taken for ages 12+; indicator covers measurements for ages 65+
Secondary (1) Indicator Method of MeasurementExamination/Laboratory
Secondary (2) Variableridageyr: Age in years
Secondary (2) Indicator Method of MeasurementQuestionnaire (interviewer-administered)
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available2013–2016
Pending Data2017–2018
Additional Data Items of InterestStage of CKD, other stratification variables of interest (disability by gender, disability by race/ethnicity)
Limitations of IndicatorSelf-reported, cross-sectional, missing data due to refusal; albuminuria single measurement
Analytic ConsiderationsAppropriate NHANES survey weights, including mobile examination center 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; albuminuria must be adjusted over multiple years
Age AdjustmentAdjusted for the distribution of age within the sample
References and Sources:
  • U.S. Department of Health and Human Services. U.S. Department of Health and Human Services Implementation Guidance on Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability status. 2011.
    http://aspe.hhs.gov/datacncl/standards/ACA/4302
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd