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Kidney Week

Abstract: PO2348

Healthy People 2020 Final Review of National CKD Objectives

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Ryskulova, Asel, Centers for Disease Control and Prevention, Hyattsville, Maryland, United States
  • Agodoa, Lawrence, National Institutes of Health, Bethesda, Maryland, United States
  • Abbott, Kevin C., National Institutes of Health, Bethesda, Maryland, United States
  • Burrows, Nilka Rios, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Background

Chronic Kidney Disease (CKD) is a significant public health problem in the United States (US) and a major source of disability and poor quality of life for those afflicted. An estimated 14.9% of adults ages 20 or older had physiological evidence of CKD determined from data collected through the 2015-18 National Health and Nutrition Examination Survey (NHANES). In 2018, more than 130,000 people in the US began treatment for end-stage kidney disease (ESKD), the final stage of CKD.

Kidney diseases are one of the leading causes of death in the US, and CKD exacts a high economic burden. Overall Medicare costs for people with CKD were over $81.8 billion in 2018, or $23,700 per person. Total Medicare spending (excluding prescription drugs) for patients with ESKD reached $36.6 billion in 2018, or $80,000 per person, accounting for about 7% of the Medicare paid claims costs.

Methods

Reflecting the importance of CKD, 24 CKD objectives were included in Healthy People 2020 (HP2020) as national health goals. These objectives focused on improving cardiovascular care in patients with CKD; increasing the proportion of patients with CKD and diabetes who received recommended evaluation and treatment; improving follow-up care in people with acute kidney injury, reducing the death rate and percentage of the US population with CKD, and increasing CKD awareness in persons with impaired kidney function.

All CKD objectives in HP2020 were measurable, having at least one data point from national data systems including the NHANES, National Death Index, and the US Renal Data System.

Results

As of the HP2020 Final Review, 15 objectives had met their target (n=11) or showed improvement (n=4). Four objectives, including CKD prevalence and awareness, showed little or no detectable change, and three objectives on receiving kidney transplant and on the number of deaths for persons with a functioning kidney transplant moved away from the target. The remaining two objectives were informational (i.e., no targets set) and were not evaluated. Disparities persisted by sex, race/ethnicity, and socioeconomic status.

Conclusion

Several of these measures will continue to be tracked over the next decade as CKD objectives in HP2030. The HP website includes HP2020 and HP2030 data.