As the US population aged 30 years and older reaches 204 million in 2020 and almost 225 million in 2030, the researchers estimate that the number of adults older than 30 years with CKD will reach 28 million in 2020, and nearly 38 million in 2030.
"We were surprised by the high probability of developing CKD during a lifetime," Dr Hoerger said in a National Kidney Foundation new release. At the individual level, for persons in the three age brackets (30 - 49, 50 - 64, and 65 years and older) with no CKD at baseline, the probable residual lifetime incidence of CKD is 54%, 52%, and 42%, respectively. By comparison, the residual rates are 12.5%, 33% to 38%, and 90% for female breast cancer, diabetes, and hypertension, respectively, among adults in the middle-age range.
Dr Hoerger and associates completed the projection study for the Centers for Disease Control and Prevention (CDC). Using a previously developed CKD health policy model, they followed individuals from their current age to death or age 90 years, to simulate the residual lifetime incidence of CKD and project the prevalence of CKD in 2020 and 2030.
The simulation sample was based on nationally representative data on persons aged 30 years and older from the National Health and Nutrition Examination Surveys, 1999 to 2010. "We focused on CKD prevalence among adults 30 years or older because [estimated glomerular filtration rate (eGFR)] typically begins declining after age 20 to 30 years," the investigators write.
The model simulates disease progression and follows persons as their eGFRs decline and/or they develop persistent albuminuria. In the model, a person's eGFR declines annually, with higher decrements in those who have certain risk factors, including diabetes, hypertension, severely increased albuminuria, or an eGFR lower than 60 mL/minute per 1.73 m2 or who are older than 50 years, when decline speeds up slightly.
The researchers acknowledge, however, that because of limited data, their model estimates are based on possibly unwarranted assumptions about steady annual decrements in eGFRs. "The assumption of constant rates is probably an oversimplification," they concede, adding that "[b]etter data for eGFR trajectories could lead to better model projections."
This study was supported by funding from the CDC. The authors have disclosed no relevant financial relationships.
Am J Kidney Dis. 2015;65:403-411. Abstract
Return to News Home
