Who Should Be Targeted for CKD Screening? Impact of Diabetes, Hypertension, and Cardiovascular Disease
Section snippets
Methods
NHANES is conducted by the National Centers for Health Statistics of the Centers for Disease Control and Prevention (CDC). NHANES 1999-2004 consisted of nationally representative cross-sectional health examination surveys using a complex stratified multistage probability cluster sampling design.9 Participants were interviewed in their homes and asked to participate in standardized medical examinations in mobile centers and provide samples for laboratory tests. Details of NHANES methods and
Results
CKD prevalence increases with age, such that for patients 60 years and older, 39.2% had evidence of CKD stages 1 through 5 and 27.6% had an eGFR less than 60 mL/min/1.73 m2 (Table 1). Based on sex, percentages ranged between 6.5% and 13.6% of men with evidence of kidney disease and between 9.7% and 17.5% of women. Similar rates of disease were evident according to racial and ethnic groups. For example, CKD stages 1 through 5 were present in 16.0% of non-Hispanic whites; 9.5% had an eGFR less
Discussion
The increasing prominence of CKD as a major public health problem has led to better understanding of the complex interrelationship among CKD, diabetes, hypertension, and cardiovascular events.2, 4, 7 Strategies to identify at-risk populations may have a public health benefit. Because cardiovascular event rates are accelerating and death rates are increased in the CKD population, intervention programs targeted at the high-risk CKD population with diabetes and hypertension may yield more active
Acknowledgements
The authors thank Chronic Disease Research Group colleagues Dana Knopic and Nan Booth, MSW, MPH, for manuscript preparation and manuscript editing, respectively, and CDC staff, including Drs Desmond Williams and Nilka Burrows, for assistance with the public health approach in CKD and its relationship to diabetes and hypertension.
Support: This study was partially funded by CDC Grant 1 U18 DP000608-01. Dr Vassalotti reports having received grant support from the CDC.
Financial Disclosure: None.
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