Prevalence and trends of chronic kidney disease and its risk factors among US adults: An analysis of NHANES 2003-18

Chronic kidney disease (CKD) is a leading cause of mortalities, morbidities, and health-care costs in the United States; however, limited number of recent studies estimated the burden of CKD and its risk factors together. This cross-sectional study estimated the age-adjusted prevalence and trends of CKD and its risk factors, and the prevalence and trends of CKD according to presence of risk factors. We analyzed National Health and Nutrition Examination Survey 2003–18 data. Individuals aged ≥20 years with albumin-creatinine ratio ≥30 mg/g or glomerular filtration rate <60 ml/min/1.73 m(2) were considered to have CKD. Following variables were considered as risk factors: hypertension, diabetes, high total cholesterol, high triglyceride, low high-density lipoprotein (HDL), obesity, abdominal obesity, insufficient aerobic physical activity (PA), and current tobacco smoking. Trends were compared by chi-square tests. The age-adjusted prevalence (95% confidence interval) for CKD was 14.1% (13.1%–15.0%), 13.0% (12.3%–13.8%), 14.0% (13.0%–15.1%), and 13.3% (12.3%–14.4%) in 2003–06, 2007–10, 2011–14, and 2015–18, respectively (p[trend] = 0.24, N = 39569). This prevalence change was also minimal for most CKD stages. Non-Hispanic blacks and low-income people had a higher prevalence than all other races/ethnicities and income groups in most periods. Among risk factors, the prevalence of diabetes, high triglyceride, high total cholesterol, low HDL, obesity, abdominal obesity, and metabolic syndrome increased (p[trend] <0.05). The prevalence of hypertension remained static. The prevalence of current tobacco smoking and insufficient aerobic PA declined. The age-adjusted prevalence of CKD has plateaued; however, the prevalence of some risk factors is increasing. Reducing the burden of these risk factors is also essential to reduce the prevalence of CKD.