Kidney Week

Abstract: SA-PO1072

CKD Awareness among US Adults by Kidney Disease: Improving Global Outcomes (KDIGO) Risk Classification

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Bragg-Gresham, Jennifer L., University of Michigan Medical School, Ann Arbor, Michigan, United States

Jennifer L. Bragg-Gresham, PhD

• Kiryakos, Jenna, University of Michigan Medical School, Ann Arbor, Michigan, United States

Jenna Kiryakos, MPH

• Heung, Michael, University of Michigan Medical School, Ann Arbor, Michigan, United States

Michael Heung, MD, MS, FASN

• Veinot, Tiffany C., University of Michigan School of Information, Ann Arbor, Michigan, United States

Tiffany C. Veinot, PhD

• Gillespie, Brenda W., University of Michigan School of Public Health, Ann Arbor, Michigan, United States

Brenda W. Gillespie, MS, PhD

• Morgenstern, Hal, University of Michigan School of Public Health, Ann Arbor, Michigan, United States

Hal Morgenstern, PhD

• Herman, William H., University of Michigan Medical School, Ann Arbor, Michigan, United States

William H. Herman, MD, MPH

• Miyamoto, Yoshihisa, Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Yoshihisa Miyamoto, MD, PhD

• Xu, Fang, Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Fang Xu, PhD

• Saran, Rajiv, University of Michigan Medical School, Ann Arbor, Michigan, United States

Rajiv Saran, MD, MBBS, MS

Background

Nearly 1 in 7 U.S. adults have chronic kidney disease (CKD); however, 9 in 10 adults with CKD do not know of their diagnosis. Improving awareness is particularly important because newer therapies are now available that can significantly improve kidney and cardiovascular outcomes in these patients. We sought to quantify awareness of CKD by eGFR and albuminuria categories among adults with a focus on stages G1–G2 with albuminuria (A2–A3), an at-risk population for CKD progression and cardiovascular disease.

Methods

Using the National Health and Nutrition Examination Survey (2017–March 2020), CKD was based on the CKD-EPI 2021 formula and albuminuria testing (urine albumin to creatinine ratio) among U.S. adults aged ≥ 20 years (N=7,671). Awareness was defined as a self-reported affirmative response to the question “Have you ever been told by a doctor or other health professional that you had weak or failing kidneys?” Analyses accounted for complex survey design and weights.

Results

Awareness of CKD was markedly lower among adults in the earlier stages of CKD (Table), especially for those with A2 category of albuminuria with eGFR ≥ 60 ml/min/1.73m². Extrapolating to the US population, this represents over 18 million U.S. adults with CKD who are unaware of the disease. Adults with CKD G5 had the highest awareness, yet 15-25% (approximately 52,000 adults) were unaware.

Conclusion

While earlier stages of CKD (G1–G3) are more prevalent in the U.S. population than advanced stages (G4–G5), adults with early-stage CKD are much less likely to be aware of their diagnosis. Most adults with albuminuria and eGFR ≥ 60 ml/min/1.73m² are unaware of having kidney disease. A limitation is that this analysis uses single measurements of these kidney markers. Raising awareness of CKD in earlier stages of the disease through increase in screening among those with risk factors may help to prompt earlier implementation of preventive strategies and could be studied further.

Funding

• Other U.S. Government Support