Chronic Kidney Disease in the United States, 2021
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When people develop chronic kidney disease (CKD), their kidneys become damaged and over time may not clean the blood as well as healthy kidneys. If kidneys do not work well, toxic waste and extra fluid accumulate in the body and may lead to high blood pressure, heart disease, stroke, and early death. However, people with CKD and people at risk for CKD can take steps to protect their kidneys with the help of their health care providers.
CKD Is Common Among US Adults
More than 1 in 7, that is 15% of US adults or 37 million people, are estimated to have CKD.*
- As many as 9 in 10 adults with CKD do not know they have CKD.
- About 2 in 5 adults with severe CKD do not know they have CKD.
CKD by Age, Sex, and Race/Ethnicity
According to current estimates:*
- CKD is more common in people aged 65 years or older (38%) than in people aged 45–64 years (12%) or 18–44 years (6%).
- CKD is slightly more common in women (14%) than men (12%).
- CKD is more common in non-Hispanic Black adults (16%) than in non-Hispanic White adults (13%) or non-Hispanic Asian adults (13%).
- About 14% of Hispanic adults have CKD.
Percentage of US Adults Aged 18 Years or Older With CKD*
*How the estimates were calculated.
Percentage of CKD stages 1–4 among US adults aged 18 years or older using data from the 2015–2018 National Health and Nutrition Examination Survey and the CKD Epidemiology Collaboration (CKD-EPI) equation. CKD stage 5 (that is, kidney failure) was not included. These estimates were based on a single measure of albuminuria or serum creatinine; they do not account for persistence of albuminuria or levels of creatinine that are higher than normal as indicated by the Kidney Disease Improving Global Outcomes recommendations. Thus, CKD in this report might be overestimated. Estimates by sex and race/ethnicity were age-standardized using the 2000 US census population; the overall percentage is unadjusted. The number of adults with CKD stages 1–4 was estimated by applying the overall percentage to the 2019 US Census population aged 18 years or older. Blood pressure-lowering medications included angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers; diagnosed diabetes was self-reported.
The following organizations** collaborated in developing and reviewing this fact sheet. Check their websites for CKD online resources for patients or providers:
- Centers for Disease Control and Prevention, Chronic Kidney Disease Initiative
- Centers for Medicare & Medicaid Services
- Kidney Interagency Coordinating Committee
- National Heart, Lung, and Blood Institute of the National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health
- United States Renal Data System
- American Association of Kidney Patients
- American Society of Nephrology
- National Kidney Foundation
- University of California, San Francisco, and University of California, San Francisco Center for Vulnerable Populations
- University of Michigan, Division of Nephrology, Department of Internal Medicine, and University of Michigan Kidney Epidemiology and Cost Center
**Links to nonfederal organizations are provided solely as a courtesy. Links do not constitute an endorsement of any organization by CDC, the Department of Army/Navy/Air Force, Department of Defense, or the federal government, and none should be inferred. CDC is not responsible for the content of individual organization’s web pages.
This publication is not subject to copyright restrictions; duplicate and distribute copies as desired.
Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2021. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2021.
- Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System https://nccd.cdc.gov/CKD. Accessed 2/19/2021.
- Kidney Disease: Improving Global Outcomes CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Inter. 2013;3(1)(suppl):1–150.
- Meisinger C, Döring A, Löwel H, KORA Study Group. Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population. Eur Heart J. 2006;27(10):1245–1250.
- National Institutes of Health. 2020 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2020.
- Tuot DS, Wong KK, Velasquez A, Crews DC, Zonderman AB, Evans MK, Powe NR. CKD awareness in the general population: performance of CKD-specific questions. Kidney Med. 2019;1(2):43–50.
- Chu CD, McCulloch CE, Banerjee T, et al; Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team. CKD awareness among US adults by future risk of kidney failure. Am J Kidney Dis. 2020;76(2):174–183.
- Yarnoff BO, Hoerger TJ, Shrestha SS, et al. Modeling the impact of obesity on the lifetime risk of chronic kidney disease in the United States using updated estimates of GFR progression from the CRIC study. PLoS One. 2018;13(10):e0205530.
- American Diabetes Association. Microvascular complications and foot care: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Suppl. 1):S151–S167.
- Astor BC, Hallan SI, Miller ER 3rd, Yeung E, Coresh J. Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the U.S. population. Am J Epidemiol. 2008;167(10):1226–1234.
- Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–1305.
- Walters BA, Hays RD, Spritzer KL, Fridman M, Carter WB. Health-related quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation. Am J Kidney Dis. 2002;40(6):1185–1194.
- Burrows NR, Vassalotti JA, Saydah SH, et al. Identifying high-risk individuals for chronic kidney disease: results of the CHERISH Community Demonstration Project. Am J Nephrol. 2018;48(6):447–455.
- Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258): 405–412.
- Adler AI, Stratton IM, Neil HA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000;321(7258):412–419.
- Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P; Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study Group. The effect of irbesartan on development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001;345(12):870–878.
- Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. N Engl J Med. 1993;329(20):1456–1462.
- Brenner BM, Cooper ME, de Zeeuw D, et al; RENAAL Study Investigators. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001; 345(12):861–869.
- Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.
- Snyder JJ, Collins AJ. Association of preventive health care with atherosclerotic heart disease and mortality in CKD. J Am Soc Nephrol. 2009;20(7):1614–1622.
- Schrauben SJ, Hsu JY, Amaral S, Anderson AH, Feldman HI, Dember LM. Effect of kidney function on relationships between lifestyle behaviors and mortality or cardiovascular outcomes: a pooled cohort analysis. J Am Soc Nephrol. 2021 Feb 5;ASN.2020040394. Online ahead of print.
- McKercher C, Sanderson K, Jose MD. Psychosocial factors in people with chronic kidney disease prior to renal replacement therapy. Nephrology (Carlton). 2013;18(9):585–591.
- Zeng X, Liu J, Tao S, Hong HG, Li Y, Fu P. Associations between socioeconomic status and chronic kidney disease: a meta-analysis. J Epidemiol Community Health. 2018;72(4):270–279.
- Banerjee T, Crews DC, Wesson DE, et al; CDC CKD Surveillance Team. Food insecurity, CKD, and subsequent ESRD in US adults. Am J Kidney Dis. 2017;70(1):38–47.
- Hoerger TJ, Wittenborn JS, Segel JE, et al. A health policy model of CKD: 2. The cost-effectiveness of microalbuminuria screening. Am J Kidney Dis. 2010;55(3):463–473.
- National Institutes of Health. Health Information: Chronic Kidney Disease website. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckdexternal icon. Accessed 2/19/2021.