Chronic Kidney Disease: A Serious Public Health Problem
Chronic kidney disease (CKD) is a serious and growing public health problem in the United States. More than 20 million Americans1 aged 20 and older may have CKD, based on a decreased glomerular filtration rate (GFR)—a measure of kidney function—or increased albuminuria, a sign of kidney damage. Although CKD is common, many Americans with the key risk factors—diabetes and high blood pressure—do not know they are at risk. The rising prevalence of obesity and diabetes is driving an increase in the burden of CKD, as well as cardiovascular disease, which is associated with CKD. Existing therapies can significantly slow the progression of CKD, yet many people who would benefit from treatment are not receiving it.
CKD and end-stage renal disease (ESRD) impose a tremendous public health burden, costing the U.S. health care system billions of dollars. In 2010, costs for Medicare patients with CKD exceeded $40 billion, accounting for 17 percent of general Medicare costs—up from six percent in 2000. Medicare spending for ESRD reached $33 billion during the same year, with total ESRD spending in the U.S. reaching almost $48 billion. Within Medicare, combined CKD and ESRD costs accounted for almost a quarter of the budget—a share slightly higher than congestive heart failure. In addition, ESRD disproportionately impacts racial and ethnic minorities, particularly African Americans, Hispanics, and Native Americans.
NKDEP: A National Response
Established in 2000 by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NKDEP aims to reduce the morbidity and mortality associated with kidney disease by promoting evidence-based interventions to improve understanding, detection, and management of kidney disease. NKDEP's chief goals are to improve early detection of CKD, facilitate identification of patients at greatest risk for progression to kidney failure, promote evidence-based interventions to slow progression of CKD, and support the coordination of Federal responses to CKD.
To achieve its goals, NKDEP works in collaboration with a range of government, nonprofit, and health care organizations to:
- raise awareness among people at risk for CKD about the need for testing;
- educate people with CKD about how to manage their disease;
- provide information, training, and tools that help health care providers better identify and manage CKD patients; and
- support health systems changes that facilitate effective CKD detection and management.
Resources to facilitate these approaches can be found in the Resource Center.
NKDEP relies on guidance from experts in the health care and public health communities, partner organizations, as well as primary and secondary research, to inform program and materials development. These experts support NKDEP through the Coordinating Panel and Working Groups.
NKDEP uses the Chronic Care Model as an organizing principle for its efforts. Read more about NKDEP’s activities and accomplishments in NKDEP: Reducing Disparities, Improving Care - A Summary Report (PDF, 1.65 MB).
April 2, 2014