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Burden of Comorbidities by CKD

According to the Dietary Guidelines for Americans 2020–2025, men should consume at least 3,400 mg of potassium per day while women should consume at least 2,600 mg of potassium per day. There is no uniform guideline of potassium intake for CKD patients. From 2005–March 2020, adults with CKD were less likely to meet daily potassium intake guidelines based on the general population compared with those without CKD.

Data Source: NHANES

To view the burden of comorbidities by risk categories, select from the drop-down menu below. Risk categories include CKD, Hypertension, Diabetes, Cardiovascular Disease, Anemia.

Hypertension (%), by CKD

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Burden of Comorbidities by CKD by Overall and Hypertension (%) National Health and Nutrition Examination Survey
Hypertension	2005-2008	2009-2012	2013-2016	2017-2020
With CKD	63.9 (95% CI: 61.3-66.5)	64.8 (95% CI: 60.6-69.1)	66.5 (95% CI: 63.4-69.6)	66.7 (95% CI: 62.5-70.8)
Without CKD	30.8 (95% CI: 29.1-32.5)	30.3 (95% CI: 28.4-32.2)	32.8 (95% CI: 31.0-34.5)	33.2 (95% CI: 30.8-35.7)

Burden of Comorbidities by CKD by Overall and Hypertension (%) National Health and Nutrition Examination Survey
Hypertension	2005-2008	2009-2012	2013-2016	2017-2020
With CKD	52.1 (95% CI: 48.9-55.3)	48.6 (95% CI: 43.6-53.7)	53.0 (95% CI: 49.6-56.4)	51.4 (95% CI: 46.2-56.5)
Without CKD	33.8 (95% CI: 32.2-35.5)	34.5 (95% CI: 32.8-36.1)	34.5 (95% CI: 32.8-36.1)	34.4 (95% CI: 32.2-36.6)

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.

Field	Data
Description of Measure	Burden of comorbidities and complications of CKD, by CKD.
Data Set	National Health and Nutrition Examination Survey (NHANES).
Population	Noninstitutionalized US adults aged ≥ 18 years, pregnant women excluded.
Years Included	2005–March 2020.
Numerator	U.S. adults aged ≥ 18 years with hypertension, diabetes, or anemia and U.S. adults aged ≥ 20 years with cardiovascular disease.
Denominator	U.S. adults aged ≥ 18 years with serum creatinine, urine albumin and creatinine, blood pressure, and hemoglobin values; self-reported diabetes and cardiovascular disease status and treatments.
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 0.9938age 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).
Cardiovacular Disease (CVD)	Cardiovascular disease is defined by a self-reported affirmative response to one or more of the questions: “Ever told had congestive heart failure?”, “Ever told had coronary heart disease?”, “Ever told you had angina/angina pectoris?”, “Ever told you had heart attack?”, or “Ever told you had stroke?”.
Anemia	Anemia is defined by hemoglobin < 13 g/dl for males and < 12 g/dl for females.
Age Standardization	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 are assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence.
Analytical Considerations	Appropriate NHANES survey weights are used for all analyses; if the relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 to be combined with later years.