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Management of Chronic Kidney Disease Stages 1–3

Slide: 7 of 29

Background: Risk Factors and Comorbidities

Chronic kidney disease (CKD) can be caused by primary kidney disease (predominantly glomerular diseases, tubulointerstitial diseases, obstruction, and polycystic kidney disease). In most patients with CKD, however, the kidney damage is associated with other medical conditions such as diabetes and hypertension. Other risk factors for CKD include older age, cardiovascular disease, obesity, family history, and African-American, Native-American, or Hispanic ethnicity.

NHANES (National Health and Nutrition Examination Survey) data from 1999–2006 estimate the prevalence of diabetes among individuals without CKD to be 5 percent and among individuals with CKD stages 1–3 to be 20 percent. Prevalence of hypertension was 24 percent among individuals without CKD, 36 percent in those with CKD stage 1, and 64 percent in those with CKD stage 3. Prevalence of cardiovascular disease was 6 percent among individuals without CKD, 7 percent in those with CKD stage 1, and 36 percent in those with CKD stage 3. When compared to the entire NHANES population, the prevalence of comorbidities was higher in the older Medicare population. Excluding those with end-stage renal disease, in 2008, 48 percent of Medicare patients with CKD had diabetes, 91 percent had hypertension, and 46 percent had atherosclerotic heart disease.