Abstract: SA-PO1132
CKD Management and Lifestyle in the United States, 2017-2023
Session Information
- CKD: Progression, Drugs, Modalities, and Environmental Factors
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Hu, Chengcheng, Emory University School of Medicine, Atlanta, Georgia, United States
- Harding, Jessica L., Emory University School of Medicine, Atlanta, Georgia, United States
Background
Chronic Kidney Disease (CKD) management is associated with slowing disease progression and reducing complications. We examined if CKD management in the U.S. changed during the COVID-19 pandemic as an indirect consequence of reduced access to healthcare, social distancing, and changed health behaviors.
Methods
Data were derived from the National Health and Nutrition Examination Survey (NHANES) for pre-pandemic (2017–March 2020) and post-pandemic (August 2021–August 2023) periods. Adults aged ≥20 years with self-reported CKD were included. Key outcomes to indicate optimal management included no smoking, leisure time physical activity, weight control, low protein and sodium intake, glycemic and blood pressure control. Poisson regression with robust standard errors and survey weights was used to estimate crude and age-adjusted prevalence ratios (PR).
Results
A total of 273 pre (median age 62 years [IQR: 44-74]; 50% men) and 163 post- (median age 68 years [IQR: 58-75]; 36% men]) pandemic NHANES participants with self-reported CKD were included. Overall, achievement of each CKD management index ranged from 87.6% for the proportion of adults not smoking, to 21.8% for the proportion of adults meeting guideline-recommend activity levels. There was no difference in CKD management between pre and post pandemic periods, with the exception of leisure time activity which increased from 21.8% to 31.0% over the time period, Table 1.
Conclusion
In this nationally representative study, CKD management is shown to be suboptimal, though COVID-19 did not appear to have any adverse impact on this.
Table 1 Comparison of CKD management pre and post the COVID-19 pandemic among NHANES participants with self-reported CKD
| CKD management indices | Pre-Pandemic Prevalence % [95%CI]) | Post-Pandemic Prevalence % [95%CI]) | Absolute Difference (%) | Crude Relative Difference (PR [95%CI]) | Age-Adjusted Relative Difference (PR [95%CI]) |
| Non smoker | 87.6 [82.2, 93.0] | 84.7 [77.2, 92.2] | -2.92 | 0.97 [0.87, 1.08] | 0.95 [0.86, 1.06] |
| Physical activity (≥ 150 minutes per week) | 21.8 [14.1, 29.5] | 31.0 [24.3, 37.7] | +9.13 | 1.42 [0.94, 2.14] | 1.57 [1.12, 2.20] |
| Not obese (BMI<30kg/m2) | 47.5 [39.2, 55.8] | 54.3 [44.0, 64.7] | +6.83 | 1.14 [0.88, 1.48] | 1.17 [0.89, 1.53] |
| Protein consumption (≤1.3 g/kg body weight/day) | 86.5 [79.6, 93.4] | 87.6 [81.9, 93.4] | +1.16 | 1.01 [0.91, 1.12] | 0.97 [0.89, 1.05] |
| Sodium consumption (< 2g/d) | 24.4 [17.7, 31.0] | 32.6 [23.9, 41.4] | +8.29 | 1.34 [0.92, 1.96] | 1.27 [0.89, 1.81] |
| Glucose control (HbA1c <7%) | 87.4 [82.8, 91.9] | 77.4 [67.2, 87.5] | -9.98 | 0.89 [0.77, 1.02] | 0.91 [0.79, 1.04] |
| Blood pressure control (SBP <120 mmHg) | 40.5 [30.8, 50.1] | 39.1 [28.8, 49.5] | -1.31 | 0.97 [0.68, 1.38] | 1.17 [0.87, 1.56] |
Acronyms: BMI = body mass index; CI = confidence interval; CKD = chronic kidney disease; HbA1c = hemoglobin A1c; NHANES = National Health and Nutrition Examination Survey; PR = prevalence ratio SBP = systolic blood pressure