Investigators Identify Demographic Trends for Chronic Kidney Disease

While the prevalence of chronic kidney disease (CKD) has stabilized in recent years in the US, it is unclear whether this trend is consistent throughout all major sociodemographic groups.

A team, led by Priya Vart, PhD, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, identified trends in the prevalence of chronic kidney disease for all major sociodemographic groups in recent years.

In the repeated cross-sectional study, the investigators analyzed data from the National Health and Nutrition Examination Surveys for 1988-1994 and every 2 years from 1999-2016 on 54,554 individuals at least 20 years old with information on race and ethnicity, socioeconomic status, and serum creatinine levels.

The mean age of the study population was 46.2 years old.

The investigators sought main outcomes of the prevalence of chronic kidney disease, defined as an estimated glomerular filtration rate of 15-59 mL/min/1.73 m².

The age-, sex-, and race/ethnicity-adjusted overall prevalence of stage 3 and 4 chronic kidney disease increased from 3.9% in the 1988-1994 time period to 5.2% in the 2003-2004 (difference, 1.3%; 95% CI, 0.9%-1.7%; P&thinsp;<&thinsp;.001 for change).

This remained relatively stable after 2004 at 5.1% in 2015-2016 (difference, −0.1%; 95% CI, −0.7% to 0.4%; P&thinsp;=&thinsp;.61 for change). The trend in adjusted disease prevalence overall differed substantially based on race/ethnicity (P = 0.009 for interaction).

This is especially true for non-Hispanic white and non-Hispanic black people, where the chronic kidney disease increased between 1988-1994 and 2003-2004 and remained stable thereafter.

For Mexican-American individuals, the prevalence of chronic kidney disease was lower than in any other racial or ethnic group and remained stable between 1988-1994 and 2003-2004. However, the prevalence in this patient group nearly doubled between 2003-2004 and 2015-2016 (difference, 2.1%; 95% CI, 0.9%-3.3%; P&thinsp;=&thinsp;.001 for change) to rates similar to those in other racial or ethnic groups.

There were higher rates of CKD prevalence among groups with lower educational level and income (eg, 5.8% vs 4.3% and 4.3% vs 3.1% in low vs high education and income, respectively, in 1988-1994).

However, trends in CKD prevalence was similar to those in the overall population.

The investigators also discovered higher disease prevalence for those with lower educational levels, while income largely remained consistent throughout the entire study period. The results were similar in most subgroups when including albuminuria to define chronic kidney disease.

“The prevalence of CKD in the United States has stabilized overall in recent years but has increased among Mexican American persons. More important, gaps in CKD prevalence across racial/ethnic groups and levels of socioeconomic status largely persisted over 28 years,” the authors wrote. “There is a need to identify and address causes of increasing CKD prevalence among Mexican American persons and a need to renew efforts to effectively mitigate persistent disparities in CKD prevalence.”

The study, “National Trends in the Prevalence of Chronic Kidney Disease Among Racial/Ethnic and Socioeconomic Status Groups, 1988-2016,” was published online in JAMA Network Open.