Chronic Kidney Disease Workgroup Objectives (13)
About the Workgroup
Approach and Rationale
Chronic kidney disease impacts more than 1 in 7 U.S. adults, or 37 million people, but 9 in 10 adults with CKD don’t know they have it.1 Blood and urine tests are used to detect kidney disease since people with early kidney disease often have no symptoms. Kidney disease puts people at risk for heart disease, infections, and early death. In some people, kidney disease may get worse over time, leading to kidney failure.
If the kidneys fail, treatments can replace the lost kidney function. These treatments include hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation. HD filters wastes and water from the blood by passing blood through a dialyzer (or filter) outside the body. PD uses the lining of the abdomen, or belly, to filter blood inside the body. Both types of dialysis require multiple treatments per week.
People on dialysis often report lower quality of life. In addition, dialysis is extremely expensive. Care for patients who receive dialysis or transplant accounts for over 7 percent of all Medicare spending even though less than 1 percent of people on Medicare receive these treatments.
The CKD Workgroup selected core objectives that aim to reduce the rates of kidney disease, slow its progression, reduce complications, and reduce related deaths. Objectives cover recommended lab tests, proven medications, and recommended vascular access for people on dialysis.2
Developmental and research objectives highlight high-priority public health issues that lack data or evidence. The CKD Workgroup selected developmental objectives that focus on key needs related to CKD in the pediatric population, vascular access in new dialysis patients, and use of new medications for reducing kidney-related complications.
CKD objectives and targets are aligned with several federal strategies and priorities and with recommendations from professional societies, including the Kidney Disease Outcomes Quality Initiative, the National Kidney Foundation (NKF), and the American Society of Nephrology. All Healthy People 2030 core objectives meet several criteria — for example, they have baseline data, a direct impact on health, and an evidence base.
Understanding Chronic Kidney Disease
CKD is a public health threat for people of all ages and racial/ethnic groups. But some people are at higher risk than others. For example, new cases of kidney disease are higher in African Americans than in white Americans. Native Hawaiians/Pacific Islanders are also at high risk for kidney disease.
Reducing these health disparities will require raising awareness of their impact, providing preventive care that is appropriate for all cultures, and removing barriers to care.
Emerging Issues in Chronic Kidney Disease
The need for culturally appropriate preventive care will grow over the decade as America continues to become more culturally diverse and older. Public health and health care systems will need to meet the growing needs of a diverse and aging population.
Because of the close association between kidney disease and diabetes, efforts to reduce diabetes may also have an impact on kidney disease.
Centers for Disease Control and Prevention. (2019). Chronic Kidney Disease in the United States, 2019. Retrieved from https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html
Inker, L. A., Astor, B. C., Fox, C. H., Isakova, T., Lash, J. P., Peralta, C. A., ... & Feldman, H. I. (2014). KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. American Journal of Kidney Diseases, 63(5), 713-735. doi: https://doi.org/10.1053/j.ajkd.2014.01.416