Prevalence and characteristics of individuals with chronic kidney disease in a large health maintenance organization

This study is designed to estimate the prevalence of and gain further insig ht into the characteristics of the chronic kidney disease (CKD) population in a large US health maintenance organization (HMO) to better understand th e CKD population in the United States overall. Analyses were performed usin g data from a staff and network model HMO in the southwestern United States with more than 150,000 members per year during 1994 to 1997, The estimated prevalence of CKD in the HMO population varied from 0.4% to 7.1%, dependin g on the definition of CKD used. Regardless of the definition, CKD was more common in men compared with women and in patients with diabetes mellitus a nd/or hypertension, Applying the age- and sex-specific prevalence rates in the HMO to the US population in 1990, we estimate there were approximately 9.1 million Americans with at least one elevated sex-specific creatinine (C r) value and approximately 4.2 million Americans with at least two elevated Cr values separated by 90 days or greater, a more rigorous definition of C KD, From these results, it is apparent that there are a large number of pat ients in the United States with CKD, Most have not been identified because screening for CKD generally is not performed. Considering the high prevalen ce of CKD and the high cost and clinical morbidity associated with end-stag e renal disease (ESRD), it is clear that CKD is an important public health problem. Early identification of patients with CKD would allow treatment th at could slow the progression to ESRD, improve clinical outcomes, and const rain the growth of costs in the ESRD program. The time has come for a struc tured public and professional educational program to address this serious c ondition. (C) 2001 by the National Kidney Foundation, Inc.