Trends for Chronic Kidney Disease (CKD)

Implications: There will be an increased use of costly diaylsis, especially among those people 70 years or older.  One would think that there would be a greater awareness of a disease consting $31 billion dollars a year.  However, this does not seem to be the case.

Analysis:  

Despite the increase in the prevalence of CKD, awareness of this debilitating condition remains low among the general public as well as with those already suffering from CKD.  Chronic Kidney Disease develops slowly and has few signs or symptoms in the early stages, making this a silent disease.  Stages 1 through 4 are classified by the extent of kidney damage and decreased kidney function.  Because the kidneys are able to compensate for a certain amount of lost function, CKD often remains unrecognized until less than 25% of normal function remains.  For instance, among those people with CKD Stage 4 (late stage), just 42%  were aware of having failing kidneys.   Currently, an estimated 26.3 million people age 20 and over (1 in 9 adults) have CKD and another 20 million adults are at increased risk of CKD.  The prevalence of CKD has increased from 10% in 1988-94 to 13.1% in 1999-2004 especially among those 70 years and older.  This increase is due to the usual culprits:  diabetes, hypertension, and obesity.  CKD is the eleventh most costly chronic medical condition in the United States.  The Centers for Disease Control estimates 100,000 U.S. adults began treatment for end-stage renal disease in 2005.  Nearly 500,000 people were receiving long-term dialysis or were living with a kidney transplant.  Medicare expenditures of approximately $20 billion for CKD accounted for 6.4% of the entire Medicare budget in 2005.  Obesity, which is trending upward in the U.S., will cause more diabetes and hypertension and therefore increased CKD.  The Center for Medicare and Medicaid Services should use a small percentage of this cost and apply it to education about and prevention of CKD.