U.S. — A recent analysis of national health survey data from 2013-2023 indicates that the prevalence of chronic kidney disease (CKD) in the U.S. has remained constant at nearly 15%. This stability persisted despite the introduction of new kidney-protective therapies and increased awareness of contributing factors like diabetes and heart failure during this period.

Chronic kidney disease affected 14.5% of the U.S. adult population during the 2013-2014 survey cycle. This figure increased slightly to 14.8% during the 2021-2023 survey cycle. The 14.8% prevalence rate in the 2021-2023 cycle represents an estimated 36 million U.S. adults.

Physician Ashish Verma and physician Sophie Claudel analyzed data from 25,106 adults aged 20 and older who participated in four National Health and Nutrition Examination Survey cycles. Verma noted that this is the initial CKD study to use recently released survey data spanning a decade, covering the period when the first specifically approved kidney-protecting therapies became available. "Remarkably, despite these advancements, overall CKD rates have remained stagnant," Verma said.

The prevalence of chronic kidney disease linked to diabetes increased from 4.7% to 5.7% between the 2013-2014 and 2021-2023 survey cycles. During the study period, diabetes had an adjusted prevalence ratio of 2.49 for CKD. The prevalence of CKD among individuals without diabetes did not change.

Heart failure also showed a connection to CKD, with an adjusted prevalence ratio of 2.47 during the 2021-2023 cycle. Claudel stated that kidney disease is increasingly associated with other conditions. "About one in four Americans with heart disease also has CKD, and the links between kidney disease, heart failure, and diabetes are getting stronger, not weaker," Claudel said.

According to CDC data, approximately 87% of adults with chronic kidney disease were unaware of their condition. Chronic kidney disease is responsible for $141 billion in annual Medicare fee-for-service spending in the U.S. Higher rates of CKD were observed among Black adults and those living below the federal poverty threshold. In 2023, chronic kidney disease was ranked as the tenth leading cause of death globally, accounting for an estimated 1.48 million deaths.

Why It Matters

The consistent prevalence of chronic kidney disease in the U.S. over a decade, despite medical advancements, underscores the ongoing public health challenge. The steady rates, particularly the increase in CKD associated with diabetes, indicate that factors contributing to the disease continue to impact a large portion of the adult population. The strong links between CKD, diabetes, and heart failure suggest a complex interplay of health conditions.

The high percentage of individuals unaware of their CKD diagnosis, coupled with the substantial economic burden on Medicare, indicates a need for increased detection and management strategies. The disproportionately higher rates among Black adults and those in lower socioeconomic groups point to disparities in health outcomes that contribute to the overall prevalence.