CDC - Chronic Kidney Disease Initiative - Projects

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Chronic Kidney Disease Initiative

Mission:

The Chronic Kidney Disease (CKD) Initiative is designed to provide comprehensive public health strategies for promoting kidney health. These strategies seek to prevent and control risk factors for CKD, to raise awareness, to promote early diagnosis, and to improve outcomes and quality of life for those living with CKD.

Partnerships:

To accomplish our goal, CDC's Division of Diabetes Translation is collaborating with other divisions and centers at CDC and developing an external partnership network with other federal agencies, national groups, and other interested partners.

Kidney Disease Interest Group at CDC is made up of the National Centers for Chronic Disease Prevention and Health Promotion, Environment Health, Health Statistics, Infection Diseases, and the Office of Public Health Genomics

Objectives:

Assess and monitor the burden of CKD and its risk factors and related preventive practices in the United States.
Develop models to assess the economic burden of CKD.
Develop methods to identify populations at risk of developing CKD.
Develop and implement public health strategies to prevent the development of CKD and reduce its progression to kidney failure and premature death.
Study the natural history of CKD.

Activities (with a sample of publications and reports)

Surveillance and Epidemiology

(1) On-going project for establishing Chronic Kidney Disease Surveillance System.

Centers for Disease Control and Prevention. United States: Chronic Kidney Disease Surveillance System. Atlanta: U.S. Department of Health and Human Services, 2010.

Plantinga LC, Crews DC, Coresh J, Miller ER III, Saran R, Yee J, Hedgeman E, Pavkov M, Eberhardt MS, Williams DE, Powe NR; CDC CKD Surveillance Team. Prevalence of chronic kidney disease in U.S. adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol 2010;5(4):673−682.

Crews DC, Plantinga LC, Miller ER III, Saran R, Hedgeman E, Saydah SH, Williams DE, Powe NR; Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team. Prevalence of chronic kidney disease in persons with undiagnosed or prehypertension in the United States. Hypertension 2010;55(5):1102−1109.

Saran R, Hedgeman E, Plantinga L, Burrows NR, Gillespie BW, Young EW, Coresh J, Pavkov M, Williams D, Powe NR; for the CKD Surveillance Team. Establishing a national chronic kidney disease surveillance system for the United States. Clin J Am Soc Nephrol 2010;5(1):152−161.

Plantinga LC, Miller ER III, Stevens LA, Saran R, Messer K, Flowers N, Geiss L, Powe NR; Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team. Blood pressure control among persons without and with chronic kidney disease: US trends and risk factors 1999–2006. Hypertension 2009;54(1):47–56.

Plantinga LC, Boulware LE, Coresh J, Stevens LA, Miller ER 3rd, Saran R, Messer KL, Levey AS, Powe NR. Patient awareness of chronic kidney disease: trends and predictors [PDF–986KB]. Arch Intern Med 2008;168(20): 2268–2275.

(2) Natural history of CKD.

O'Hare AM, Hailpern SM, Pavkov ME, Rios-Burrows N, Gupta I, Maynard C, Todd-Stenberg J, Rodriguez RA, Hemmelgarn BR, Saran R, Williams DE. Prognostic implications of the urinary albumin to creatinine ratio in veterans of different ages with diabetes. Arch Intern Med 2010;170(11):930−936.

(3) Supplement kidney measures in the National Health and Nutrition Examination Survey (NHANES) in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. The protocol for blood and urine collection for the Kidney Disease Profile is available at http://www.cdc.gov/nchs/data/nhanes/nhanes_05_06/lab_d.pdf [PDF–127KB]

(4) Intramural research on the burden of CKD in the general and in special populations, e.g., mortality among people with chronic kidney disease and incidence of kidney failure among people with diabetes, among other topics.

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Health Outcomes and Economics

(1) Cost of illness study, including direct and indirect costs.

(2) Cost-effectiveness study using a lifetime simulation model to assess the costs and benefits of various interventions.

Hoerger TJ, Wittenborn JS, Segel JE, Burrows NR, Imai K, Eggers P, Pavkov ME, Jordan R, Hailpern SM, Schoolwerth AC, Williams DE; Centers for Disease Control and Prevention CKD Initiative. A health policy model of CKD: 1. model construction, assumptions, and validation of health consequences [PDF–457KB]. Am J Kidney Dis 2010;55(3):452–62.

Hoerger TJ, Wittenborn JS, Segel JE, Burrows NR, Imai K, Eggers P, Pavkov ME, Jordan R, Hailpern SM, Schoolwerth AC, Williams DE; Centers for Disease Control and Prevention CKD Initiative. A health policy model of CKD: 2. The cost-effectiveness of microalbuminuria screening [PDF–831KB]. Am J Kidney Dis 2010;55(3):463–73.

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CKD Health Evaluation and Risk Information Sharing (CHERISH)

On-going project for identifying individuals at high risk for CKD in the United States.

Vassalotti JA, Fox CH, Becker BN. Risk factors and screening for chronic kidney disease [PDF–128KB]. Adv Chronic Kidney Dis 2010;17(3):237–45.

Collins AJ, Vassalotti JA, Wang C, Li S, Gilbertson DT, Liu J, Foley RN, Chen SC, Arneson TJ. Who should be targeted for CKD screening? Impact of diabetes, hypertension, and cardiovascular disease [PDF–337KB]. Am J Kidney Dis 2009;53(3 Suppl 3):S71–7.

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Expert Consensus to Establish Priorities and Strategies

Expert panel meeting to lay the framework for comprehensive public health strategies for preventing the development and progression, and complications of CKD.

Powe NR, Plantinga L, Saran R. Public health surveillance of CKD: principles, steps, and challenges [PDF–357KB]. Am J Kidney Dis 2009;53(3 Suppl 3):S37−S45.

Albright A, Burrows NR, Jordan R, Williams DE. The Kidney Disease Initiative and the Division of Diabetes Translation at the Centers for Disease Control and Prevention [PDF–160KB]. Am J Kidney Dis 2009;53(3 Suppl 3):S121–5.

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CKD Health Policy

(1) Created the National CKD Fact Sheet 2010 [PDF – 300KB] in collaboration with other federal agencies, academia, national organizations, and other partners, to provide a consensus document about the burden of CKD in the United States.

(2) Provide assistance and technical consultation on the development of Healthy People 2020 objectives related to kidney disease.

(3) Participate in the Kidney Interagency Coordinating Committee (KICC), which seeks to foster collaboration between the federal agencies involved in kidney disease.

Narva AS, Briggs M, Jordan R, Pavkov ME, Burrows NR, Williams DE. Toward a more collaborative federal response to chronic kidney disease. Adv Chronic Kidney Dis 2010;17(3):282−288.

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Additional References

Schoolwerth AC, Engelgau MM, Hostetter TH, Rufo KH, Chianchiano D, McClellan WM, Warnock DG, Vinicor F. Chronic kidney disease: a public health problem that needs a public health action plan [PDF – 191KB]. Prev Chronic Dis 2006;3(2):A57.

Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS. Prevalence of chronic kidney disease in the United States. JAMA 2007;298(17):2038–47.

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Morbidity and Mortality Weekly Reports (MMWR)

Vital Signs: Central Line–Associated Blood Stream Infections—United States, 2001, 2008, and 2009

Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons With Diagnosed Diabetes — United States and Puerto Rico, 1996–2007

Prevalence of Chronic Kidney Disease and Associated Risk Factors United States, 1999–2004

Hospitalization Discharge Diagnoses for Kidney Disease — United States, 1980–2005

Kidney Disease Mortality — Michigan, 1989–2005

Incidence of End-Stage Renal Disease among Persons with Diabetes — United States, 1990–2002

Racial Differences in Trends of End-Stage Renal Disease, by Primary Diagnosis — United States, 1994–2004

State-Specific Trends in Chronic Kidney Failure — United States, 1990–2001

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