Trends in Prevalence of Chronic Kidney Disease in the United States.

<bold>Background: </bold>Trends in the prevalence of chronic kidney disease (CKD) are important for health care policy and planning.<bold>Objective: </bold>To update trends in CKD prevalence.<bold>Design: </bold>Repeated cross-sectional study.<bold>Setting: </bold>NHANES (National Health and Nutrition Examination Survey) for 1988 to 1994 and every 2 years from 1999 to 2012.<bold>Participants: </bold>Adults aged 20 years or older.<bold>Measurements: </bold>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.<bold>Results: </bold>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.<bold>Limitation: </bold>Serum creatinine and albuminuria were measured only once in each person.<bold>Conclusion: </bold>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.<bold>Primary Funding Source: </bold>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]