Indicator Definitions – Chronic Kidney Disease

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Chronic kidney disease (CKD) is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Excess fluid and waste from the blood remain in the body, potentially causing other health problems. CKD is also associated with heart disease and stroke.

CKD is a common disease, impacting more than 1 in 7 U.S. adults (38 million). As many as 9 in 10 adults with CKD do not know they have it. Some health consequences of CKD include anemia (low red blood cell count), frequent infections, low calcium levels, high potassium and phosphorus levels in the blood, loss of appetite, and depression or lower quality of life. Kidney disease can get worse over time and may lead to kidney failure or end-stage kidney disease (ESKD). The good news is you can help prevent CKD and lower the risk for kidney failure by knowing risk factors for CKD, getting tested yearly, making necessary lifestyle changes, taking medicine as needed, and seeing your health care team regularly.

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Chronic Kidney Disease Initiative
Visit Chronic Kidney Disease Initiative | CDC for more information.

Definition Details

Incidence of treated end-stage kidney disease
Population: All residents
Numerator: Number of new patients requiring dialysis or transplantation during a calendar yearA
Denominator: Midyear resident population for the same calendar year
Measure: Annual incidence number (crude and adjusted by age, sex, race, and ethnicity) [cases per 1,000,000]
Time Period of Case Definition: Calendar year
Summary: The number of patients with newly registered end-stage kidney disease (ESKD), or kidney failure, increased from 94,466 in 2000 to 134,862 in 2019 (43% increase).1 However, there were 130,522 newly registered ESRD cases in 2020, representing about a 3.2% decrease from 2019.1 The age, sex, and race/ethnicity adjusted incidence of ESKD increases with age. In 2020, the incidence was 12 per million population (pmp) among individuals aged 0–17 years, while it was 1,447 pmp among individuals aged ≥75 years.1 Diabetes and hypertension are the leading causes of ESKD in the United States. Diabetes and chronic heart failure accounted for about 60% and 28%, respectively, of new cases of ESKD in 2020.1 Chronic kidney disease can be detected early through simple blood and urine tests. Taking medications, making lifestyle changes, and keeping blood sugar and blood pressure under control can help prevent chronic kidney disease and otherdiabetes complications.2
Notes: The ESKD population includes dialysis and kidney transplant recipients. The estimates are based on Census Bureau and Centers for Medicare and Medicaid Services (CMS) Medical Evidence Form (CMS 2728) data collections.3 The denominator is the general population and is not specific to the population at risk of developing ESKD. Since data are available only for patients whose ESKD therapies are reported to CMS, patients who die of ESKD before receiving treatment or whose therapies are not reported to CMS are not included in the United States Renal Data System (USRDS) database.
Data Source: United States Renal Data System (USRDS)
Related Objectives or Recommendations: HHealthy People 2030 objective: CKD-07. Reduce the rate of new cases of end-stage kidney disease.
Related CDI Topic Area: None
Reference 1: United States Renal Data System. 2022 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2022. https://adr.usrds.org/2022
Reference 2: Chronic Kidney Disease Initiative. Chronic Kidney Disease Basics. Centers for Disease Control and Prevention. Accessed April 5, 2023. https://www.cdc.gov/kidneydisease/basics.html
Reference 3: Office of Disease Prevention and Health Promotion. Healthy People 2030: Objectives and Data. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Accessed April 5, 2023. https://health.gov/healthypeople

Additional Data Sources

Kidney Disease (CKD)
Kidney Disease (CKD) Surveillance System
Kidney Disease (CKD) Surveillance System (cdc.gov)
PLACES: Local Data for Better Health
PLACES: LOcal Data for Better Health
PLACES: Local Data for Better Health | CDC