Chronic Kidney Disease in United States

United States

Chronic kidney disease (CKD), also known as chronic renal disease, reduces the ability of the kidneys to filter blood and can lead to permanent organ damage. CKD can be caused by antecedent kidney conditions or autoimmune diseases, but the majority of cases are attributable to diabetes and high blood pressure. Other risk factors include heart disease and a family history of kidney failure.

Since chronic kidney disease progresses slowly over a long period of time, it often goes undiagnosed. Nine in 10 adults with CKD do not know that they have it. Early screening is essential for those at higher risk of chronic kidney disease, such as those with a family history of CKD or those with past kidney damage. CKD is associated with cognitive and physical impairment and, if left untreated, may lead to kidney failure, heart attack or stroke. In 2020, chronic kidney disease accounted for more than $85 billion in Medicare costs.

According to America’s Health Rankings data, the prevalence of chronic kidney disease is higher among:

• Women compared with men.
• Adults ages 65 and older compared with younger adults.
• American Indian/Alaska Native adults compared with Asian adults.
• Adults with less than a high school education compared with those with higher educational attainment. 
• Adults with an annual household income less than $25,000 compared with those with higher levels of income.
• Adults living in non-metropolitan areas compared with those in metropolitan areas.
• Adults who have difficulty with self-care compared with adults without a disability.
• Straight adults compared with LGBQ+ adults.
• Adults who have served in the U.S. armed forces compared with those who have not served. 

Since there is no cure for chronic kidney disease, prevention is important. Prevention strategies include increasing physical activity, not smoking or quitting smoking, eating less salt and sugar, managing blood pressure and having kidney function checked during routine visits, especially for individuals who are at risk for CKD or have diabetes. 

Chronic kidney disease can be managed. People with CKD can take measures to slow its progression, including:

• Keeping blood pressure below 140/90 mm Hg (or the target set by a doctor).
• Staying in the target blood sugar range for those with diabetes.
• Creating a kidney-healthy eating plan with a dietitian.
• Maintaining a healthy weight. 
• Taking medications as instructed by a doctor.

Healthy People 2030 has several objectives related to chronic kidney disease, including:

• Reducing the proportion of adults with chronic kidney disease.
• Increasing the proportion of persons with chronic kidney disease who know they have it.

Centers for Disease Control and Prevention. “Chronic Kidney Disease in the United States, 2023.” Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2023. https://www.cdc.gov/kidneydisease/publications-resources/CKD-national-facts.html.

United States Renal Data System. “Chronic Kidney Disease: Healthcare Expenditures for Persons with CKD.” In 2022 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, Chapter 6. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2022. https://adr.usrds.org/2022/chronic-kidney-disease/6-healthcare-expenditures-for-persons-with-ckd.

Weiner, Daniel E., and Stephen L. Seliger. “Cognitive and Physical Function in Chronic Kidney Disease.” Current Opinion in Nephrology and Hypertension 23, no. 3 (May 2014): 291–97. https://doi.org/10.1097/01.mnh.0000444821.87873.7b.