Lifetime Kidney Disease Risk High in the U.S.

More than half of Americans born today will develop chronic kidney disease (CKD) stage 3 or higher during their lifetime, according to an estimate based on findings from a simulation study.

At birth, individuals have a 59.1% overall lifetime risk of CKD stages 3a or higher, researchers reported online ahead of print in the American Journal of Kidney Diseases. They also have a 33.6%, 11.5%, and 3.6% overall lifetime risk of CKD stage 3b or higher, CKD stage 4 or higher, and end-stage renal disease (ESRD), respectively.

Morgan E. Grams, MD, MHS, and collaborators at Johns Hopkins University School of Medicine in Baltimore defined CKD stage 3a or higher, 3b or higher, and 4 or higher as an estimated glomerular filtration rate (eGFR) below 60, below 45, and below 30 mL/min/1.73 m2, respectively. They defined ESRD as chronic kidney failure treated with dialysis or kidney transplantation.

Additionally, the study showed women had a greater CKD risk yet lower ESRD risk than men. Compared with white men and women, black men and women had markedly higher risks of CKD stage 4 or higher (15.8% and 18.5%, respectively, vs. 9.3% and 11.4%, respectively) and ESRD (8.5% and 7.8% vs. 3.3% and 2.2%).

The investigators stated that their estimates of lifetime ESRD risk and the dramatic racial disparities in kidney disease risk are consistent with previous studies.

For their study, Dr. Gram's group estimated CKD prevalence using data from the National Health and Nutrition Examination Survey, a population-level survey of community-dwelling U.S. civilians. The incidence and prevalence of ESRD were provided by the U.S. Renal Data System in five- to 10-year age intervals.

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