Management of Chronic Kidney Disease Stages 1–3
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.
- Fink HA, Ishani A, Taylor BC, et al. Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review No. 37 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. HHSA 290-2007-10064-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC075-EF. Available at www.effectivehealthcare.ahrq.gov/ckd.cfm.
- Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey. Questionnaires, Datasets, and Related Documentation. Available at www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm. Accessed February 9, 2012.
- Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA 2007 Nov 7;298(17):2038-47. PMID: 17986697.
Your slide tray is being processed.