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Abstract: FR-OR112

The Epidemiology of CKD from 1990 to 2016 in the United States of America: An Analysis of the Global Burden of Disease Study

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Bowe, Benjamin Charles, VA Saint Louis Health Care System, Saint Louis, Missouri, United States
  • Xie, Yan, VA Saint Louis Health Care System, Saint Louis, Missouri, United States
  • Li, Tingting, VA Saint Louis Health Care System, Saint Louis, Missouri, United States
  • Yan, Yan, VA Saint Louis Health Care System, Saint Louis, Missouri, United States
  • Xian, Hong, VA Saint Louis Health Care System, Saint Louis, Missouri, United States
  • Al-Aly, Ziyad, VA Saint Louis Health Care System, Saint Louis, Missouri, United States

Group or Team Name

  • Clinical Epidemiology Center
Background

Over the last 3 decades, the United States experienced significant changes in demographic, social, and epidemiologic trends; these changes likely have contributed to changes in chronic kidney disease (CKD) epidemiology.

Methods

We used the Global Burden of Disease (GBD) study data and methodologies to describe the change in burden of CKD from 1990 to 2016 involving disability adjusted-life years (DALYs) and death.

Results

Between 1990 and 2016, CKD DALYs increased by 104.7% from 945,627 (UI: 837,774-1,053,428) to 1,935,953 (1,747,356-2,124,794). Death due to CKD increased by 149.5% from 33,080 (UI: 3 2,382-33,721) to 82,539 (UI: 80,297-84,652). All states exhibited increase in CKD burden, but there was remarkable heterogeneity in rate of change. In 2016, the burden varied greatly by state, where Mississippi (the state with the highest burden) had twice the age-standardized CKD DALY rate compared to Vermont (the state with the lowest burden), 697(UI:619-778) and 321 (UI:280-363), respectively. In the US, 37.8%, 35.6%, and 26.7% of the increase in DALYs was attributable to increased risk factor exposure, population growth, and aging, respectively. Decomposition analyses showed substantial increase in metabolic, and to a lesser extent dietary, risk factors which manifested in increase in CKD due to diabetes, and to a lesser extent hypertension. CKD due to diabetes was the primary contributor for increased probability of death due to CKD among those aged 20-54; among those aged 55-89, the increase in probability of death was driven by CKD due to diabetes and decreased probability of death from causes other than CKD. Improvement in socio-demographic (SDI) development was coupled with an increase in age-standardized DALY rates. Rate of change in burden of CKD outpaced rate of change of other non-communicable diseases, and rate of change of CKD in all SDI levels.

Conclusion

The US toll of CKD is significant, rising, and substantially variable among states; it is driven by increased risk factor exposure and demographic expansion leading to increased probability of death from CKD among working adults; the rate of change in CKD burden outpaced other diseases in the US and CKD in other areas of the world.

Funding

  • Veterans Affairs Support