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Overall prevalence of CKD increasing with higher rates of diabetes, hypertension, study data show

Wednesday, December 12 2007 | Comments

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What's This? The prevalence of chronic kidney disease in the United States in the period from 1999 to 2004 is greater than it was in the period from 1988 to 1994, due in part to increasing prevalence of diabetes and hypertension, study data indicate.

Researchers conducted a cross-sectional analysis of data from the most recent NHANES surveys, which contained data from a nationally representative sample of noninstitutionalized adults aged 20 years or older during the period from 1988 to 1994 (n=15,488) and the period from 1999 to 2004 (n=13,233). The goal of the study was to update the estimated prevalence of CKD in the United States.

The prevalence of both albuminuria and decreased glomerular filtration rate increased from the period from 1988 to 1994 to the period from 1999 to 2004; specifically, the prevalence of CKD stages 1 to 4 increased from 10.0% (95% CI, 9.2%-10.9%) during the period from 1988 to 1994 to 13.1% (95% CI, 12%-14.1%) during the period from 1999 to 2004. This translated to a prevalence ratio of 1.3 (95% CI, 1.2-1.4).

In fully adjusted multivariate analysis, the prevalence of albuminuria was strongly associated with diagnosed diabetes (OR, 3.58; 95% CI, 3.12-4.12) and hypertension (OR, 1.70; 95% CI, 1.10-1.92), as well as older age and all nonwhite race/ethnicity groups (P<.001 for all). Similarly, the prevalence of low GFR was strongly associated with diagnosed diabetes (OR, 1.54; 95% CI, 1.28-1.80) and hypertension (OR, 1.98; 95% CI, 1.73-2.67), as well as higher body mass index (OR, 1.08; 95% CI, 1.02-1.15) and older age (P<.001 for all).

"The increasing prevalence of diagnosed diabetes and hypertension has contributed to this increase [in CKD incidence], which may propagate to higher rates of complications and kidney failure requiring dialysis or transplantation," the authors of the study concluded. "The high prevalence of CKD overall, and particularly among older individuals and persons with hypertension and diabetes, suggests that CKD needs to be a central part of future public health planning." (Coresh J, et al. JAMA 2007;298:2038-2047.)

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