Abstract: SA-PO0387
Age-Stratified Analysis of CKD and Diabetes Trends: Questioning the Adequacy of Uniform Diagnostic Criteria
Session Information
- CKM: Clinical - Epidemiology and Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Khan, Moiz A., HCA Healthcare Inc, Nashville, Tennessee, United States
- 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
Chronic Kidney Disease (CKD) and diabetes share a well-established bidirectional relationship, yet population-level surveillance rarely interrogates whether standard diagnostic thresholds perform equally across the lifespan. While rising diabetes prevalence is documented nationally, it remains unclear whether uniform eGFR and albuminuria based CKD criteria capture disease burden accurately across age groups. We examined age-stratified trends in CKD and diabetes prevalence to assess potential diagnostic gaps.
Methods
NHANES data (1999–2020) were analyzed for adults and adolescents ages 12–84. CKD (stage ≥1) was defined using eGFR and urine albumin-to-creatinine ratio per KDIGO criteria. Diabetes and prediabetes were identified via self-report, HbA1c (≥6.5%; 5.7–6.4%), and fasting plasma glucose (>137; 117–137 mg/dL). Cohorts were stratified into youth (12–30), middle-aged (31–59), and elderly (60–84). For each group, weighted linear regression observed trends over time, and ordinary linear regression examined the association between CKD and diabetes.
Results
Across the full population, both CKD (slope: 0.17%/year, p=0.010) and diabetes (slope: 1.0%/year, p<0.001) rose significantly, with a strong CKD-diabetes correlation (coefficient of determination=0.64, p=0.006). Diabetes increased significantly in all three age strata (youth p=0.0003; middle-aged p<0.001; elderly p<0.001). However, CKD prevalence showed no significant increase in any individual age group (youth p=0.47; middle-aged p=0.09; elderly p=0.29), and CKD-diabetes correlations within these individual age groups were non-significant.
Conclusion
Our findings suggest that uniform diagnostic criteria may not adequately capture CKD burden across all age groups. Despite rising diabetes prevalence in youth, middle-aged, and elderly populations alike, CKD trends remained flat within each group, pointing to a potential disconnect between true disease burden and what current thresholds detect. Given that eGFR naturally varies with age, a uniform cutoff may lead to underdiagnosis in younger individuals and overdiagnosis in the elderly. Adopting age-calibrated CKD definitions, as proposed in recent nephrology literature, could meaningfully improve diagnostic accuracy and early identification of diabetic kidney disease across the lifespan.