Disease Management

Half of American adults may have chronic kidney disease in their future

Chronic kidney disease (CKD) threatens to become a major health burden in coming years—and that may come as news to many of the Americans who will be affected, according to a study in the American Journal of Kidney Diseases. As the authors put it, awareness of CKD “remains low in the United States, and few estimates of its future burden exist.” In fact, according to federal government health surveys, less than 10% of Americans with the early stages of CKD are aware of their condition.

Researchers at RTI International, a not-for-profit research group, used their own previously developed CKD Health Policy Model to make their predictions. By their reckoning, more than half (54%) of Americans ages 30 and older who don’t currently have CKD will develop the condition some time in their lives.

Lifetime incidence risk for common causes of morbidity when no disease is present at age 30, U.S. population

*Index age 45.
CKD=chronic kidney disease.
Sources: SEER Cancer Statistics Review, JAMA.

They also forecast a ramping up of CKD prevalence from the current level of 13.2% to 14.4% in 2020 (28 million Americans). By 2030, their model projects the prevalence will reach 16.7% (38 million Americans).

Estimated prevalence, CKD, U.S. population, 2015–2030

Source: Hoerger TJ et al., American Journal of Kidney Diseases, March 2015.

Lead author Thomas Hoerger, PhD, tells Managed Care that the group’s results argue for “interventions to control the conditions that increase the risk of CKD (primarily, tight glycemic control for persons with diabetes and better blood pressure control for persons with hypertension), and [also] partly for the development of new interventions to slow progression among persons in the early stages of CKD.”

The main risk factors for CKD include diabetes, hypertension, and age. Early detection and treatment of CKD can forestall or delay heart disease and kidney failure. Likewise, early treatment of diabetes and hypertension can prevent CKD from developing.

However, as Hoerger and his colleagues point out, the clinical significance of early stage CKD among the elderly with borderline numbers is somewhat debatable, partly because of competing health problems.

Even if these CKD forecasts come true, there’s good news about one of its most dire consequences, end-stage renal disease (ESRD).

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