The crude prevalence of chronic kidney disease (CKD) stages 3–5 within the Military Health System (MHS) has remained < 6% of service members and their dependents having eGFR below 60 ml/min/1.73 m2 from 2016–2019. The trend in prevalence has been consistent from 2016 to 2019. Crude prevalence of CKD stages 3–5 tended to be much higher among service members and dependents aged ≥70 years than their younger counterparts. Prevalence tended to be higher among men than women (5.6% vs. 5.0% in 2019). The prevalence of CKD stages 3–5 tended to be highest among Black service members and their dependents compared to other known racial groups.
To view the prevalence of CKD stages 3–5 in MHS by risk categories, select from the drop-down menu below. Risk categories include: Overall, Age Category, Sex, and Race.
The majority of service members and their dependents did not have eGFR estimates (73%) and were assumed to not have eGFR <60 ml/min/1.73m2; therefore, prevalence may be underestimated. Data are not adjusted.
The US Department of Defense Military Health System (MHS) provides comprehensive primary and specialty care for more than 9.6 million active-duty personnel and military retirees and their families worldwide. The MHS Data Repository (MDR) is the administrative claims database for all care received through MHS, including direct care received in military treatment facilities and purchased care received in civilian treatment facilities. The MDR does not capture health care delivery in combat zones or care received in the VHA system. All patients were in the TRICARE Prime managed care option. Data are from both the direct care (military facilities) and private care (private facilities through TRICARE coverage) systems.
De-identified patient data were obtained from the MHS data repository. Data contain both the estimated glomerular filtration rate (eGFR) definition of chronic kidney disease (CKD) and claims-based CKD defined by using ICD-9-CM and ICD-10-CM codes diagnosis codes with at least one inpatient or two outpatient CKD diagnoses. To be included in analyses, service members and their dependents had to have at least one inpatient or outpatient record during the fiscal year (October 1 to September 30). Data cells with 10 or fewer patients were suppressed.
Disclaimer: The views expressed are those of the authors and do not reflect the official policy of the Uniformed Services University, Departments of Army/Navy/Air Force, Department of Defense, Centers for Disease Control and Prevention, Department of Health and Human Services, or US government.
Prevalence of CKD stages 3–5 in the Military Health System (MHS).
U.S. Department of Defense MHS Data Repository (MDR). MDR source files: CAPER (direct care outpatient claims), SIDR (direct care inpatient claims), TED-NI (purchased care outpatient claims), TED-I Header (purchased care inpatient claims), and VM6BEN (demographic information from the Defense Enrollment Eligibility Reporting System).
Service members and their dependents in MHS.
2016–2019.
Service members and their dependents with eGFR <60 ml/min/1.73m2 for at least 90 days.
Service members and their dependents with at least one outpatient or inpatient visit during the fiscal year (October 1 to September 30).
CKD is defined by estimated glomerular filtration rate (eGFR): stage 3: eGFR 30–59 ml/min/1.73 m²; stage 4: eGFR 15–29 ml/min/1.73 m²; stage 5: eGFR <15 ml/min/1.73 m² for at least 90 days, excluding dialysis or transplant patients.
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
Laboratory measurements taken during MHS visits.
Data is only available through 2019. The majority of service members and their dependents did not have eGFR estimates (73%) and were assumed to not have eGFR <60 ml/min/1.73m2; therefore, prevalence may be underestimated.
Service members and their dependents in MHS tend to be younger and healthier than the general population. Therefore, testing for serum creatinine and UACR are performed less frequently than in other health care systems.