A new study reports that the proportion of Americans with chronic kidney disease (CKD) linked to diabetes has increased over the past decade, while overall CKD rates have remained unchanged. The findings were published on Jul. 8 and analyzed data from 25,106 adults between 2013 and 2023 in the National Health and Nutrition Examination Survey.
The researchers found that while about one in seven U.S. adults had CKD both in 2013 and in 2023, cases specifically associated with diabetes rose from 4.7% to 5.7%, marking a relative increase of approximately 30%. Kidney disease not linked to diabetes held steady during this period.
"Our study reveals a concerning trend in the United States, where CKD is increasingly associated with diabetes. This is the first CKD study to utilize the recently released survey data spanning a decade, encompassing the period during which the first therapies specifically approved to protect the kidneys, namely SGLT2 inhibitors and finerenone (a nonsteroidal mineralocorticoid receptor antagonist (MRA) that mitigates the risk of kidney failure), were introduced into the market. Remarkably, despite these advancements, overall CKD rates have remained stagnant. This finding underscores the urgent need for further research and intervention to address the escalating burden of CKD in the context of diabetes," said corresponding author Ashish Verma, MBBS, assistant professor of medicine at Boston University Chobanian & Avedisian School of Medicine.
The analysis included two types of tests for each participant: estimated glomerular filtration rate from blood samples and urine albumin-to-creatinine ratio from urine samples. Anyone with an abnormal result on either test was classified as having CKD. The researchers tracked changes by age, sex, race and ethnicity, income level, educational attainment, as well as health conditions such as high blood pressure or heart disease.
In addition to rising cases among people with diabetes, results showed a widening incidence gap based on educational attainment; social and economic factors appeared influential alongside biological ones. Rates among men increased slightly while remaining stable among women; Black Americans continued to experience higher rates—close to one in five—compared with white Americans over ten years.
First author Sophie Claudel, MD, said, "What we're seeing is that kidney disease no longer travels alone. About one in four Americans with heart disease also has CKD, and the links between kidney disease, heart failure, and diabetes are getting stronger, not weaker. This is what the American Heart Association now calls cardiovascular-kidney-metabolic syndrome, and it means single-organ care isn't enough."
