Comprehensive trends in Chronic Kidney Disease prevalence and comorbidities across eGFR and albuminuria categories: a 20-year analysis of NHANES data

Chronic kidney disease (CKD) represents a major public health challenge, contributing to over 1.2 million global deaths annually and ranking as the 12th leading cause of mortality. This study provides a 20-year trend analysis (1999-2018) of CKD prevalence and its associated comorbidities among adults in the United States using the NHANES dataset. Employing the CKD-EPI 2021 equation without the race component, the study revealed a stable CKD prevalence of 20% in adults aged ≥20 years, alongside trends in nine comorbidities. Obesity and diabetes showed significant increases, while hypertension, anemia, hyperkalemia, and cardiovascular disease remained stable. Hypertriglyceridemia and hypercholesterolemia exhibited an initial rise followed by a plateau. The analysis highlights the uneven distribution of CKD comorbidities across KDIGO-defined eGFR and albuminuria subcategories, with G3bA2 and G4A1 patients at heightened risk. These findings underscore the importance of targeted interventions through an individualized care strategy that considers CKD risk category and the comorbidities profiles. Additionally, it offers pivotal epidemiological insights to inform clinical research, policymaking, and precision medicine in nephrology.