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.[2]​​[3][4][5]

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).[3][6][7]

Prevalence in the US adult population is estimated to be 14% (approximately 35.5 million people) for CKD stages 1-4, based on data from 2017 to 2020.[8] CKD is more common in older people: prevalence is 38.4% in people aged 70 years and over in the US, 18.5% in those aged 60-69 years, 10.9% in those aged 40-59 years, and 6.1% in those aged 18-39 years (2017-2020 data). CDC Kidney Disease Surveillance System: tracking and preventing kidney disease in America Opens in new window

In the US, prevalence of CKD is higher in non-Hispanic black adults (20%) than other ethnic groups (non-Hispanic Asian adults 14%; Hispanic adults 14%; and non-Hispanic white adults 12%).[8]​ In the UK, black and minority ethnic groups have higher rates of end-stage kidney disease and are affected at younger ages than white ethnic groups.[9]

CKD is associated with significant disparities with respect to race and socioeconomic status.[10][11]​​​​ While post hoc analysis of results from the ACCORD study failed to identify significant differences in incident CKD between black and white clinical trial participants (median follow-up 4.7 years), the age-standardised incidence of end-stage kidney disease was approximately 2.5 times higher among black people than white people in the US in 2016.[12][13]​​ The results suggest that equitable healthcare delivery for patients with diabetes may reduce racial disparities in diabetes-associated CKD.

Globally, people from low- and lower-middle-income countries are disproportionately affected by CKD. Access to care, especially kidney replacement therapy, is often lacking.[4][5]​​

Comorbidity is common

In one large cross-sectional study, 98.2% of adults with CKD had at least one comorbidity, and the mean number of comorbidities was 3.8 (standard deviation [SD] 2.2).[14]​ Extreme levels of comorbidity (≥7 conditions) were >40 times more common than in the control group. These comorbidities were categorised as concordant physical health conditions (e.g., hypertension, diabetes), discordant physical health conditions (e.g., rheumatological conditions, inflammatory bowel disease), and mental health conditions (e.g., depression, substance misuse). After adjustment for age, sex, and deprivation, all concordant conditions, >70% of discordant physical health conditions, and 75% of mental health conditions, were significantly more common in people with CKD.[14]

Use of this content is subject to our disclaimer