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No increase in prevalence of chronic kidney disease since 2003

Researchers have found that since 2003 to 2004, there has been no significant increase in the prevalence of stage 3 and stage 4 chronic kidney disease in the United States.

“Chronic kidney disease epidemiology in its own right has received much attention over the past dozen years and has been incorporated into programs of nationwide health promotion and disease prevention goals,” Daniel Murphy, MD, from the department of medicine at University of Minnesota, and colleagues wrote. “The goal of our study was to provide updated estimates of [chronic kidney disease (CKD)] prevalence in the United States.”

The researchers evaluated CKD prevalence in the U.S. by obtaining data from the National Health and Nutrition Examination Survey (NHANES) from 1988 to 1994 through 2011 to 2012. The survey contained data from U.S. residents aged 20 years or older with available serum creatinine measurements. CKD stage 3 and stage 4 were defined as an estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1.73m², which was calculated with the Chronic Kidney Disease Epidemiology Collaboration equation. This rate was later expanded to include patients with an eGFR of at least 60 mL/min/1.73m² and a one-time urine albumin-creatinine ratio (ACR) of at least 30 mg/g.

They found that the prevalence of stage 3 and stage 4 CKD increased from the late 1990s until the early 2000s, but leveled off since 2003 to 2004. In 1988 to 1994, the prevalence was 4.8% (95% CI, 4.3-5.4), and in 2003 to 2004, the prevalence was 6.9% (95% CI, 5.9-7.9). Prevalence has remained at 6.9% until 2011 to 2012. After adjustment for age, sex, race/ethnicity, and diabetes mellitus status, there was little difference in the overall prevalence of stage 3 and stage 4 CKD (P = 0.26).

“CKD is a signicant but often underappreciated public health concern... [It] is silent until very advanced stages and requires urine and blood testing for diagnosis,” Linda F. Fried, MD, MPH, and Paul M. Palevsky, MD, from the VA Pittsburgh Healthcare System and University of Pittsburgh, wrote in an accompanying editorial. “Although the data showing stabilization in CKD prevalence are cause for optimism, the underlying reason for the bending of the CKD prevalence curve is uncertain.” – by Rafi Naseer

Disclosure: The researchers report no relevant financial disclosures.