Epidemiology of Kidney Disease in the United States: Highlights from the Centers for Disease Control and Prevention Kidney Disease Surveillance System.

Kidney diseases are an important public health problem, rising in global significance. In place for nearly 2 decades, the Centers for Disease Control and Prevention's Kidney Disease Surveillance System is the first comprehensive surveillance system developed in the United States, focused exclusively on tracking kidney disease before ESKD. The Kidney Disease Surveillance System incorporates key data and trends from multiple, large national-level survey data sources (National Health and Nutrition Examination Survey), electronic medical record data (Military and Veterans Affairs Health Systems), health care claims (Medicare, Optum), and social determinants of health (American Community Survey). The prevalence of CKD among civilian US adults remains steady between 13% and 14%. The prevalence is higher among older, female, non-Hispanic Black adults and those with diabetes or hypertension. Among US veterans, the incidence of CKD and rates of diagnosis of AKI increased from 2008 to 2022 (incidence: 62.8 to 71.5/1000 person-years, AKI: 84.9 to 241.7 cases/1000 person-years). Awareness of the disease nationwide among persons with CKD has historically been low (<10%), but starting in 2013, has increased to approximately 25%. Persons with CKD self-report more problems with sleep, and those aged 65 years and older self-report a higher prevalence of functional limitations. Improvements in quality-of-care measures, including medication prescription and increase in both serum creatinine and albuminuria testing were observed. Increased self-reported physical activity was observed among persons with CKD. Food insecurity increased among persons with CKD, with the highest prevalence in young, female, non-Hispanic Black, and Hispanic adults. Although population-level prevalence of CKD remains stable, higher AKI and CKD rates are being observed in health systems settings. This project's website can be found at https://wwwn.cdc.gov/KDSS/ . Robust surveillance is key to raising awareness of kidney disease, its risk factors, care quality, and outcomes. Surveillance findings may inform policy and evidence-based practices that reduce premature morbidity and mortality, improve quality of life, and reduce cost.