Abstract: TH-PO0561
CKD Among Medicare Beneficiaries by Rural Status
Session Information
- CKD: From Global Burden to Precision Care - Epidemiology, Demographics, Geographies, and Risk Factors
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Bragg-Gresham, Jennifer L., University of Michigan Medical School, Ann Arbor, Michigan, United States
- Licon, Ana Laura, University of Michigan Medical School, Ann Arbor, Michigan, United States
- Kime, Alexander, University of Michigan Medical School, Ann Arbor, Michigan, United States
- Saran, Rajiv, University of Michigan Medical School, Ann Arbor, Michigan, United States
Background
Americans living in rural areas face a higher burden of kidney disease, with significantly higher rates of both CKD and ESRD compared to those in urban areas. This may be driven by higher rates of risk factors like diabetes and hypertension but may also be connected to environmental factors. Key challenges for rural residents can be limited access to specialized care, long travel distances to care, and shortage of rural facilities.
Methods
Using data on over 3 million Medicare beneficiaries from 2022, we estimated the county-level prevalence of CKD and examined this by rural/urban status using the 2013 NCHS Urban-Rural Classification Scheme for Counties, ranging from 1 (large central metro) to 6 (noncore: urban cluster of < 10,000 population). CKD was determined by ICD-10 diagnosis codes. Counties with fewer than 11 beneficiaries with CKD diagnosis were suppressed. ArcGIS was used to create bivariate distribution maps, by tertiles of each measure. Darker pink color indicates a higher prevalence of CKD while darker teal color indicates more rural counties. Dark purple counties are rural counties in the highest tertile of CKD prevalence. All of which likely contribute to higher mortality rates and late diagnoses of CKD.
Results
Out of the 2,907 counties with prevalence data, almost 40% are classified as noncore, with only 2% of counties classified as large central metro. Examining the bivariate distribution, a large number of rural counties with a high prevalence of diagnosed CKD appear in northern Michigan, northern New England, along the Appalachian Mountain range, and scattered through the Great Plains.
Conclusion
To improve care for rural residents with kidney disease, technologies such as telemedicine may be needed, along with an effort to increase the workforce supporting these communities.
Funding
- Other U.S. Government Support