Abstract: PUB079
Age-Related Trends in Diabetes and CKD Prevalence in the United States
Session Information
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Khan, Moiz A., St George's University, Saint George's, Saint George, Grenada
- Khan, Fahd, Stony Brook University, Stony Brook, New York, United States
- Nagabandi, Nikhil, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Potter, Mary K, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States
Background
Diabetes and Chronic Kidney Disease (CKD) have a long-known and complex interplay. In the United States, the increasing prevalence of Diabetes has been well studied, particularly in the elderly population. Recent research has observed the prevalence of CKD due to diabetic nephropathy, but has not focused on age-stratified trends of CKD and its direct relationship to the growing burden of diabetes. This study examines the prevalence of CKD and its association with diabetes across age-stratified groups.
Methods
Data from the National Health and Nutrition Examination Survey (NHANES) during 1999-2020 was analyzed. The estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR) were used with the KDIGO criteria to determine people with stage ≥1 CKD. The NHANES listed individuals who self-reported a diagnosis of diabetes or prediabetes but did not distinguish between diabetes type 1 and 2. Hemoglobin A1C and fasting plasma glucose (FPG) were used to determine undiagnosed diabetes (A1C ≥ 6.5% or FPG >137 mg/dL) and undiagnosed prediabetes (5.7% ≤ A1C < 6.5% or 117mg/dL ≤ FPG ≤ 137mg/dL). Analyses were conducted on the total population (ages 12-84) and stratified into youth (ages 12-30), middle-aged (ages 31-59), and elderly (ages 60-84) groups. For each group, weighted linear regression observed trends over time, and ordinary linear regression examined the association between CKD and diabetes.
Results
For both CKD and diabetes prevalence, a significant (p<0.05) increase was observed across the entire population: (CKD: slope 0.17%/year, diabetes: slope 1.0%/year). For diabetes prevalence across the youth, middle aged, and elderly groups, a significant (p<0.05) increase was found (0.0027,1.0,1.0 %/year respectively). However, no significant increase in CKD prevalence was observed within any of these individual age groups.
Conclusion
Our findings suggest that current diagnostic criteria may not adequately capture early-stage CKD in younger populations. Given that eGFR naturally varies with age, a uniform threshold may lead to underdiagnosis in youth and overdiagnosis in the elderly. Adopting age-calibrated definitions of CKD, as proposed in recent literature, could improve diagnostic accuracy across age groups.