title: Lifetime incidence of CKD stages 3-5 in the United States.
abstract: BACKGROUND
  Lifetime risk estimates of chronic kidney disease (CKD) can motivate preventative behaviors at the individual level and forecast disease burden and health care use at the population level.
  
  
  METHODS
  Markov Monte Carlo model simulation study.
  
  
  METHODS
  Current US black and white population.
  
  
  METHODS
  Markov models simulating kidney disease development, using an individual perspective and lifetime horizon.
  
  
  RESULTS
  Age-, sex-, and race-specific residual lifetime risks of CKD stages 3a+ (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m²), 3b+ (eGFR <45 mL/min/1.73 m²), 4+ (eGFR <30 mL/min/1.73 m²), and end-stage renal disease (ESRD).
  
  
  METHODS
  State transition probabilities of developing CKD and of dying prior to its development were modeled using: (1) mortality rates from the National Vital Statistics Report, (2) mortality risk estimates from a 2-million person meta-analysis, and (3) CKD prevalence from National Health and Nutrition Examination Surveys. Incidence, prevalence, and mortality related to ESRD were supplied by the US Renal Data System.
  
  
  RESULTS
  At birth, the overall lifetime risks of CKD stages 3a+, 3b+, 4+, and ESRD were 59.1%, 33.6%, 11.5%, and 3.6%, respectively. Women experienced greater CKD risk yet lower ESRD risk than men; blacks of both sexes had markedly higher CKD stage 4+ and ESRD risks (lifetime risks for white men, white women, black men, and black women, respectively: CKD stage 3a+, 53.6%, 64.9%, 51.8%, and 63.6%; CKD stage 3b+, 29.0%, 36.7%, 33.7%, and 40.2%; CKD stage 4+, 9.3%, 11.4%, 15.8%, and 18.5%; and ESRD, 3.3%, 2.2%, 8.5%, and 7.8%). Risk of CKD increased with age, with approximately one-half the CKD stage 3a+ cases developing after 70 years of age.
  
  
  CONCLUSIONS
  CKD incidence was modeled from prevalence estimates in the US population.
  
  
  CONCLUSIONS
  In the United States, the lifetime risk of developing CKD stage 3a+ is high, emphasizing the importance of primary prevention and effective therapy to reduce CKD-related morbidity and mortality.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. mgrams2@jhmi.edu
authors.forename: Morgan E
authors.initials: ME
authors.lastname: Grams
authors.forename: Eric K H
authors.initials: EK
authors.lastname: Chow
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Chronic kidney disease; end-stage renal disease; incidence; lifetime risk