Kidney Week

Abstract: FR-OR24

Changes in CKD Prevalence in the United States Using the Age-Adapted CKD Classification System

Session Information

• CKD: Clinical Outcomes, Trials, Mechanistic Insights
  November 04, 2022 | Location: W307, Orange County Convention Center‚ West Building
  Abstract Time: 04:57 PM - 05:06 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Tio, Maria Clarissa, University of Mississippi Medical Center, Jackson, Mississippi, United States

Maria Clarissa Tio, MD, MPH, FASN

• Syed, Aliba, University of California Irvine, Irvine, California, United States

Aliba Syed,

• Streja, Elani, University of California Irvine, Irvine, California, United States

Elani Streja,

• Talluri, Rajesh, University of Mississippi Medical Center, Jackson, Mississippi, United States

Rajesh Talluri,

• Obi, Yoshitsugu, University of Mississippi Medical Center, Jackson, Mississippi, United States

Yoshitsugu Obi,

• Shafi, Tariq, University of Mississippi Medical Center, Jackson, Mississippi, United States

Tariq Shafi,

• Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States

Kamyar Kalantar-Zadeh,

Background

Current eGFR criteria for diagnosing CKD (eGFR<60 mL/min/1.73m²) do not take an individual’s age into consideration. An age-adapted CKD definition was recently proposed (JASN 2019). We determined the changes in CKD prevalence in the US, comparing the current KDIGO classification system (CKD-KDIGO) to an age-adapted CKD classification system (CKD-Age).

Methods

We analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES; N=8,016). CKD-KDIGO was defined as having a CKD-EPI 2021 eGFR <60 mL/min/1.73m² or ACR ≥30 mg/g. CKD-Age was defined as proposed: eGFR <75 mL/min/1.73m² for ages 18 to <40 years, eGFR <60 mL/min/1.73m² for ages 40 to 65 years, eGFR <45 mL/min/1.73m² for ages >65 years, or ACR ≥30 mg/g. We used reclassification tables to determine changes in CKD prevalence.

Results

The US CKD population has a mean age of 60 years. Among the 31 million persons with CKD-KDIGO, 39.4% were 18 to <40 years old, 43.4% were 40-65 years, and 17.2% were >65 years. Median age is 71 years for CKD-KDIGO G3A, 76 years for G3B, 78 years for G4, and 63 years for G5. Using the CKD-Age classification, 5.2 million (16.7%) of those with CKD-KDIGO were reclassified to being CKD-free (Table 1). 1.2 million (0.6%) of those without CKD were reclassified to having CKD-Age and all of these individuals were 40-65 years old.

Conclusion

Age-based CKD classification may prevent overdiagnosis of CKD in older individuals and identify younger individuals with low eGFR at risk for kidney failure, allowing prioritization of care.

Funding

• Other NIH Support