Ann Intern Med

BackgroundTrends in the prevalence of chronic kidney disease (CKD) are important for health-care policy and planning.ObjectiveTo update trends in CKD prevalence.DesignRepeated cross-sectional study.SettingNational Health and Nutrition Examination Survey (NHANES) in 1988\u201394 and every two years from 1999 to 2012.ParticipantsAdults 20 years or older.MeasurementsCKD (stages 3\u20134) was defined using glomerular filtration rate (GFR) estimated with the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation from calibrated serum creatinine measurements (eGFR 15\u201359 ml/min/1.73m2). An expanded definition of CKD also included persons with an eGFR 6560 ml/min/1.73m2 and a one-time urine albumin-to-creatinine ratio 6530 mg/g.ResultsAn increase in the unadjusted prevalence of stages 3\u20134 CKD occurred from the late 1990s to the early 2000\u2019s. Since 2003\u201304, however, the prevalence of stages 3\u20134 CKD overall has largely stabilized (e.g. 6.9% prevalence of stage 3\u20134 CKD in 2003\u201304 and 6.9% prevalence in 2011\u201312). There was little difference in adjusted prevalence of stage 3\u20134 CKD overall comparing 2003\u201304 and 2011\u201312 after controlling for age, sex, race/ethnicity, and diabetes mellitus status (p=0.26). Lack of increase in CKD prevalence since the early 2000\u2019s was observed in most subgroups and with an expanded definition of CKD which included persons with higher eGFRs but with albuminuria.LimitationsSerum creatinine and albuminuria were measured only once in each subject.ConclusionsIn a reversal of prior trends, there has been no appreciable increase in the prevalence of stages 3\u20134 CKD in the U.S. population overall during the most recent decade.K24 DK092291/DK/NIDDK NIH HHS/United StatesU58 DP003839/DP/NCCDPHP CDC HHS/United States2017-10-04T00:00:00Z27479614PMC5552458vault:2482