Epidemiology

Chronic kidney disease (CKD) is a common condition that is often unrecognised until the most advanced stages. It is estimated that 9% to 13% of the adult population worldwide has CKD.[4][5][6] In 2017, the estimated worldwide prevalence of CKD stages 1 to 2 accounted for 5%, stage 3 for 3.9%, stage 4 for 0.16%, stage 5 for 0.07%, dialysis for 0.041%, and kidney transplantation for 0.011%.[6] The global prevalence of CKD is rising and is thought to be due to an ageing population; a higher incidence of diseases such as diabetes and hypertension, which are the most common causes in the adult population; and an increased incidence of glomerular disorders such as focal segmental glomerulosclerosis.[5][7][8] Black people, Hispanic people, and those with a family member who has a diagnosis of kidney disease have a higher prevalence than the general population.[9][10] Additionally, individuals with an episode of acute kidney injury are most likely to be at risk for chronic kidney injury and end-stage kidney disease in the future.[11]

CKD is a condition associated with high racial and socioeconomic disparities. In 2016, the age-standardised incidence of end-stage renal disease was almost threefold higher among black people compared with white people in the US, whereas data from the ACCORD study revealed that race was not associated with accelerated development and progression of CKD in participants who received standardised medical care.[12] The results suggest that equitable health care delivery for patients with diabetes may reduce racial disparities in diabetes-associated CKD.

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