Murphy, Daniel, McCulloch, Charles E., Feng Lin, Banerjee, Tanushree, Bragg-Gresham, Jennifer L., Eberhardt, Mark S., Morgenstern, Hal, Pavkov, Meda E., Saran, Rajiv, Powe, Neil R., Chi-yuan Hsu, Lin, Feng, Hsu, Chi-Yuan, and Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
Background: Trends in the prevalence of chronic kidney disease (CKD) are important for health care policy and planning.Objective: To update trends in CKD prevalence.Design: Repeated cross-sectional study.Setting: NHANES (National Health and Nutrition Examination Survey) for 1988 to 1994 and every 2 years from 1999 to 2012.Participants: Adults aged 20 years or older.Measurements: Chronic kidney disease (stages 3 and 4) was defined as an estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1.73 m2, estimated with the Chronic Kidney Disease Epidemiology Collaboration equation from calibrated serum creatinine measurements. An expanded definition of CKD also included persons with an eGFR of at least 60 mL/min/1.73 m2 and a 1-time urine albumin-creatinine ratio of at least 30 mg/g.Results: The unadjusted prevalence of stage 3 and 4 CKD increased from the late 1990s to the early 2000s. Since 2003 to 2004, however, the overall prevalence has largely stabilized (for example, 6.9% prevalence in 2003 to 2004 and in 2011 to 2012). There was little difference in adjusted prevalence of stage 3 and 4 CKD overall in 2003 to 2004 versus 2011 to 2012 after age, sex, race/ethnicity, and diabetes mellitus status were controlled for (P = 0.26). Lack of increase in CKD prevalence since the early 2000s was observed in most subgroups and with an expanded definition of CKD that included persons with higher eGFRs and albuminuria.Limitation: Serum creatinine and albuminuria were measured only once in each person.Conclusion: In a reversal of prior trends, there has been no appreciable increase in the prevalence of stage 3 and 4 CKD in the U.S. population overall during the most recent decade.Primary Funding Source: American Society of Nephrology Foundation for Kidney Research Student Scholar Grant Program, Centers for Disease Control and Prevention, and National Institutes of Health. [ABSTRACT FROM AUTHOR]