The prevalence of stage 3 and 4 chronic kidney disease (CKD) in the US population overall during the most recent decade has shown no appreciable increase, indicating a reversal of prior trends nationwide, according to a recent study. The National Health and Nutrition Examination Survey looked at trends in CKD for 1988 to 1994 and every 2 years from 1999 to 2012 in adults aged ≥20 years. Researchers found:

• From the late 1990s to the early 2000s, the prevalence of stage 3 and 4 CKD increased.

• Since 2003 to 2004, however, the overall prevalence had stabilized (eg, 6.9% prevalence in 2003 to 2004 and in 2011 to 2012).

• There was little difference in adjusted prevalence of stage 3 and 4 CKD overall in 2003 to 2004 vs 2011 to 2012 after age, sex, race/ethnicity, and diabetes status were controlled for (p=0.26).

• Lack of CKD prevalence since the early 2000s was observed in most subgroups.

Citation: Murphy D, McCulloch CE, Lin F, et al. Trends in prevalence of chronic kidney disease in the United States. [Published online ahead of print August 2, 2016]. Ann Intern Med. doi:10.7326/M16-0273.

Commentary: CKD is important as a risk factor for CV disease, acute kidney injury, and death. In addition, CKD is important to be aware of when prescribing many medications in which the pharmacokinetics of the medication are influenced by kidney function. It is reassuring to see that despite the aging of the population, as well as increases in the prevalence of obesity and diabetes, the prevalence of chronic kidney disease has stabilized. This is likely due to the hard work of primary care physicians in treating high blood pressure, improving glycemic control for patients with diabetes, and the increased use of ACE inhibitors—all of which provide renal protection and are apparently enough to offset the increase in CKD that would otherwise have been expected over the last 10 years. —Neil Skolnik, MD