Rise In Chronic Kidney Disease Prevalence In USA Due Partly To Increase In Diabetes And Hypertension

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Main Category: Urology / Nephrology
Also Included In: Diabetes;  Hypertension;  Obesity / Weight Loss / Fitness
Article Date: 08 Nov 2007 - 0:00 PDT

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It is estimated that the prevalence of chronic kidney disease among adults in the United States has risen to 13%, party due to the rise in the number of people with diabetes and hypertension, according to an article in the Journal of the American Medical Association (JAMA).

Recognized today as a common condition, CKD (chronic kidney disease) increases your chances of cardiovascular disease as well as kidney failure, plus some other complications. The authors explain that the number of people with kidney failure treated by dialysis and transplantation in the USA has increased considerably. The incidence of end-stage renal disease has also risen substantially.

The researchers write "Estimation of the prevalence of earlier stages of CKD in the U.S. population and ascertainment of trends over time is central to disease management and prevention planning, particularly given the increase in the prevalence of obesity, diabetes, and hypertension, the leading risk factors for CKD." We are not sure whether there have been changes in the prevalence of earlier stages of CKD.

Josef Coresh, M.D., Ph.D., Johns Hopkins University, Baltimore, and team examined the National Health and Nutrition Examination Surveys (NHANES 1988-1994 [n = 15,488] and NHANES 1999-2004 [n = 13,233]) to compare the prevalence, stages and severity of CKD. NHANES is seen as a nationally representative sample of people aged 20 years or more.

Prevalence of CKD was determined by persistent presence of excessive protein in the urine (albuminuria) and decreased estimated GFR (glomerular filtration rate) - a measurement of fluid which is filtered by the kidney(s).

The scientists found that the prevalence of albuminuria, as well as the decreased GFR increased from 1988-1994 to 1999-2004. CKD stages 1-4 prevalence rose from 10% in 1988-1994 to 13.1% in 1999-2004. Increases in diabetes, hypertension and higher BMI (body mass index) prevalence accounted for the whole increase in albuminuria prevalence. However, only part of the increase in decreased GFR prevalence was due to increases in diabetes, hypertension and higher BMI. Change in average serum creatinine accounted for part of the raised prevalence of CKD, the writers explained.

The researchers wrote "In conclusion, survey data suggest that the prevalence of CKD in the United States is high and has increased between 1988-1994 and 1999-2004, from 10 percent to 13 percent, while awareness of kidney disease among the general public remains very low. The increasing prevalence of diagnosed diabetes and hypertension has contributed to this increase, which may propagate to higher rates of complications and kidney failure requiring dialysis or transplantation. Earlier stages accounted for most of the individuals with CKD. Because individuals with early stages of CKD have a higher risk of cardiovascular disease morbidity and mortality than their risk of progression to kidney failure, cardiovascular risk factor management in this group is critical. 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."

"Prevalence of Chronic Kidney Disease in the United States"
Josef Coresh, MD, PhD; Elizabeth Selvin, PhD, MPH; Lesley A. Stevens, MD, MS; Jane Manzi, PhD; John W. Kusek, PhD; Paul Eggers, PhD; Frederick Van Lente, PhD; Andrew S. Levey, MD
JAMA. 2007;298(17):2038-2047.
Click here to view abstract online

Written by - Christian Nordqvist
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