A 20-year analysis of NHANES data revealed a stable CKD prevalence of approximately 20% in US adults, with uneven distribution of comorbidities across KDIGO-defined eGFR and albuminuria subcategories, highlighting G3bA2 and G4A1 patients as being at heightened risk.
CKD prevalence remained stable at approximately 20% among US adults aged ≥20 years over the 20-year study period from 1999 to 2018.
Obesity and diabetes showed significant increases among CKD patients over the 20-year study period.
Hypertension, anemia, hyperkalemia, and cardiovascular disease remained stable as comorbidities in CKD patients over the study period.
Hypertriglyceridemia and hypercholesterolemia showed an initial rise followed by a plateau over the study period.
CKD comorbidities were unevenly distributed across KDIGO-defined eGFR and albuminuria subcategories, with G3bA2 and G4A1 patients identified as being at heightened risk.
CKD contributes to over 1.2 million global deaths annually and ranks as the 12th leading cause of mortality worldwide.
This research suggests that chronic kidney disease (CKD) affects about 1 in 5 American adults and has remained at that level for at least two decades (1999–2018). To arrive at this finding, researchers analyzed a large, nationally representative U.S. health survey (NHANES) and used an updated formula to estimate kidney function that does not factor in a patient's race. While the overall rate of CKD held steady, the health problems that tend to accompany it did not all follow the same pattern: obesity and diabetes grew significantly, lipid disorders like high cholesterol and high triglycerides rose and then leveled off, and conditions like high blood pressure, anemia, high potassium, and heart disease stayed roughly constant throughout the period. A particularly important finding is that the burden of these additional health problems is not spread evenly among all CKD patients. People in specific kidney disease severity categories — particularly those with moderately reduced kidney function and moderate protein in their urine (G3bA2), or those with severely reduced kidney function but little protein in their urine (G4A1) — appear to carry a disproportionately higher risk. This suggests that simply knowing someone has CKD is not enough; the specific combination of kidney function level and protein leakage into urine matters when assessing a patient's overall health risk. This research suggests that one-size-fits-all approaches to managing CKD may be insufficient. The findings point toward the value of tailored, individualized care strategies that account for where a patient falls within the kidney disease spectrum and which specific accompanying conditions they have. The data also provide a foundation for policymakers, clinicians, and researchers to better prioritize resources and design interventions for the groups at greatest risk.
Farag Y, Zheng Z, Dar A, Tariq A. (2026). Comprehensive trends in Chronic Kidney Disease prevalence and comorbidities across eGFR and albuminuria categories: a 20-year analysis of NHANES data.. Renal failure. https://doi.org/10.1080/0886022X.2025.2536192