Chronic kidney disease (CKD) affects more than 1 in 7 U.S. adults—an estimated 37 million Americans.1 For Americans with diabetes or high blood pressure—the two most common causes of kidney disease—the risk for CKD is even greater. Nearly 1 in 3 people with diabetes and 1 in 5 people with high blood pressure have kidney disease.1 Other risk factors for developing kidney disease include heart disease and a family history of kidney failure.
Despite the prevalence of kidney disease in the United States, as many as 9 in 10 adults who have CKD are not aware they have the disease.1 Early-stage kidney disease usually has no symptoms, and many people don’t know they have CKD until it is very advanced. Kidney disease often gets worse over time and may lead to kidney failure and other health problems, such as stroke or heart attack. Approximately 2 in 1,000 Americans are living with end-stage kidney disease (ESKD)—kidney failure that is treated with a kidney transplant or dialysis.2
Learn more about kidney disease from the National Institute on Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK spearheads research to improve kidney disease management and treatment. For information about current studies, visit ClinicalTrials.gov.
Nearly 808,000 people in the United States are living with ESKD, also known as end-stage renal disease (ESRD), with 69% on dialysis and 31% with a kidney transplant.
Men are 1.6 times more likely to develop ESKD than women.
Compared with White people
Black people are nearly 4 times more likely to develop ESKD.
Hispanic people and Native American people are more than twice as likely to develop ESKD.
Asian people are 1.4 times more likely to develop ESKD.
Black people make up about 13% of the total population but account for 30% of the people with ESKD in the United States.
Black people are more likely to have ESKD caused by high blood pressure, also called hypertension, than White or Hispanic people.
Since 2000, the number of Hispanic, Native Hawaiian and Other Pacific Islander, and Asian people with kidney failure has more than tripled in each race/ethnicity group.
Hispanic people are more likely to have ESKD caused by diabetes than White or Black people.
At the end of 2020, 13.7% of all patients undergoing dialysis performed dialysis at home. The percentage of patients performing home dialysis increased approximately 50% between 2010 and 2020.
Among patients with ESKD who were initially waitlisted for a kidney transplant in 2015, more than half (55.7%) received a kidney transplant by the end of 5 years.
Children 17 years or younger were more likely to receive a transplant by 5 years (92.9%) than adults (39.0% to 65.8%, depending on age bracket).
Women were more likely to receive a transplant by 5 years (57.4%) than men (54.8%).
White people were more likely to receive a transplant by 5 years (63.2%) than Black, Hispanic, and Asian people (approximately 50%) and Native American and Native Hawaiian/Pacific Islander people (approximately 40%).
Annual per-person spending attributable to Medicare Parts A, B, and D was more than double for beneficiaries ages 66 or older with CKD ($25,920) compared with those without CKD ($12,332).
In 2020, the adjusted mortality rate was more than twice as high among Medicare beneficiaries ages 66 years or older with CKD (103.9 per 1,000 person-years) than among those without CKD (47.9 per 1,000).
Adjusted mortality among people with CKD increased from 91.7 per 1,000 in 2019 to 100.6 per 1,000 in 2020, with a greater increase among Black and Hispanic people with CKD than among their White counterparts.
Mortality increased by 23% among Black people.
Mortality increased by approximately 12% among Hispanic people.
Mortality increased by approximately 9% among White people.
Adjusted mortality in patients with ESKD decreased between 2010 (151.6 per 1,000) and 2019 (129.1 per 1,000) before abruptly increasing in 2020 (152.1 per 1,000).
In patients receiving hemodialysis, adjusted mortality increased by nearly 17% from 2019 to 2020.
In patients receiving peritoneal dialysis, adjusted mortality increased by 20% from 2019 to 2020.
In patients with a kidney transplant, adjusted mortality increased by 33% from 2019 to 2020.
Adjusted mortality is significantly lower in patients with a kidney transplant (63.9 per 1,000) than in patients receiving dialysis (186.0 per 1,000).
References
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.