What is Chronic Kidney Disease?
Chronic kidney disease (CKD) means your kidneys are damaged and losing their ability to keep you healthy. In the early stages of the disease, most people do not have symptoms. But as CKD gets worse, wastes can build up in your blood and make you feel sick. You may develop other problems like high blood pressure, anemia, weak bones, poor nutritional health, and nerve damage. Because kidneys are vital to so many of the body’s functions, CKD also increases your risk of having heart and blood vessel disease. While these problems may happen slowly and without symptoms, they can lead to kidney failure, which can appear without warning. Once kidneys fail, dialysis or a kidney transplant is needed to stay alive.
What Causes CKD?
The two main causes of CKD are diabetes and high blood pressure. These two conditions were the primary diagnosis in 75% of kidney failure cases between 2015-2017: 47% of new ESKD patients had a primary diagnosis of diabetes, the leading cause of ESKD, while 29% of new ESKD patients had a primary diagnosis of hypertension, the second leading cause of ESKD. Other conditions that can lead to ESKD are: glomerulonephritis (diseases that damage the kidney's filtering units), which are the third most common type of CKD; inherited diseases, such as polycystic kidney disease; malformations at birth that occur as a fetus develops; lupus and other immune diseases; obstructions such as kidney stones or an enlarged prostate; and repeated urinary tract infections.
People with CKD are at greater risk for cardiovascular disease and death at all stages of CKD. CKD and heart disease are linked and have common risk factors, such as diabetes and hypertension. Each condition can lead to or worsen the other.
How Big is This Problem? How Many Lives Are Affected?
An estimated 37 million American adults (1 in 7 adults; 15% of adults) are estimated to have CKD, but most don’t know they have it. In fact, about 1 in 2 people with very low kidney function (not on dialysis) don’t know they have CKD. Approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may have CKD. In 2017, 746,557 Americans had kidney failure, and needed dialysis or a kidney transplant to survive. Nearly 500,000 of these patients received dialysis at least 3 times per week to replace kidney function. Nearly 125,000 people started ESKD treatment in 2017, of which 120,834 started dialysis, and 20,945 received a kidney transplant. At the end of 2017, more than 222,848 Americans were living with a kidney transplant.
Only 23,400 Americans received a kidney transplant in 2019, while about 100,000 Americans are waiting for one. Less than one-third of these transplants came from living donors. Living and deceased kidney donors are crucial: 12 people die every day while waiting for a kidney transplant. Over 3,500 kidneys from deceased donors are surgically discarded each year; NKF is making efforts to utilize more of these kidneys for transplantation. People with CKD are five to ten times more likely to die prematurely than they are to progress to ESKD. Over 100,000 people with ESKD died in 2017.
Populations:
Who is at Risk for CKD?
1 in 3 American adults is at risk for CKD. Some demographic groups are at higher risk. Risk factors for CKD include: diabetes; high blood pressure; family history of kidney failure; age 60 or older; obesity; heart disease; past damage to kidneys; and being in minority populations that have rates of diabetes or high blood pressure, such as African Americans, Hispanics, Asians, Pacific Islanders, and Native Americans.
The risk of developing ESKD among African Americans is roughly 3 times higher than Whites. Compared to non-Hispanics, Hispanics are almost 1.3 times more likely to receive a diagnosis of kidney failure. Asians and Native Americans also have a higher prevalence of CKD than Whites. Minority groups are at increased risk of progressing from CKD to ESRD and of progressing more rapidly. Non-Hispanic African-American and Hispanic people experience more rapid decline of kidney function than non-Hispanic Whites. There are disparities in the quality of primary care for patients of different racial, ethnic, and socioeconomic groups who have CKD and CKD risk factors. These disparities are related to patient, clinician, clinical, and systemic factors.
Patients receiving dialysis in areas with populations that are largely African American, low-income, or of lower educational attainment, are less likely to have received pre-dialysis care from a nephrologist. One study found that 52% of Hispanic patients on hemodialysis and not received pre-dialysis care from a nephrologist, compared to 44% of non-Hispanic patients. However, healthcare professionals are becoming increasingly aware of the importance of nonmedical factors on health, such as where and how a person lives. Primary care teams can help reduce these disparities through concerted action.
Many children and adolescents have conditions that, if left untreated, dramatically increase their risk for CKD and ESKD: about 4% of youths (12–19 yrs) in the U.S. have hypertension, while about 10% have elevated blood pressure. In children aged 2-19 years, the prevalence of obesity is 18.5% (about 13 million), and 193,000 people younger than 20 years are living with diagnosed diabetes. The growing prevalence of these conditions in children means that the incidence and prevalence of CKD will likely increase further in the coming years.
Children and Adolescents with CKD 5,814 children (<18 yrs old) in the U.S. lived with ESKD in 2017. They are 30 times more likely to die prematurely than healthy children. For instance, in one study, adolescents (<18 yrs old) with ESKD since childhood had a life expectancy of 38 years if they were treated with dialysis during childhood, and 63 years if they received a kidney transplant during childhood.
The primary causes of pediatric ESKDin the U.S. between 2012-2016 were: primary glomerular disease (22.3%), CAKUT (congenital anomalies of the kidney and urinary tract; 21.9%), cystic/hereditary/congenital disorders (11.7%), and secondary glomerular disease/vasculitis (10.1 %). Urinary tract infections can also lead to kidney infections, which can cause long-term damage to the kidneys.
In 2019, 760 children (<18 yrs old) received a kidney transplant and more than 1,000 children (<18 yrs old) are waiting for a donated kidney.
Reference(Read more): https://www.kidney.org/news/newsroom/factsheets/KidneyDiseaseBasics
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