Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey

TLDR

Chronic kidney disease is a major risk factor for death and cardiovascular morbidity, yet Canadian prevalence estimates have largely been inferred from end‑stage renal disease data. The study used direct kidney function measurements from 3,689 adults in the 2007‑2009 Canadian Health Measures Survey to estimate CKD prevalence, calculate age‑standardized cardiovascular risk factor prevalence by CKD group, and cross‑tabulate eGFR with albuminuria status. CKD affected 12.5 % of Canadian adults (≈3 million), with 3.1 % having stage 3‑5 disease and 10.3 % exhibiting albuminuria; diabetes, hypertension, and hypertriglyceridemia were more common in CKD, albuminuria remained high even among those with normal eGFR or without diabetes/hypertension, and awareness of stage 3‑5 CKD was only 12 %, underscoring missed opportunities for early intervention.

Abstract

Chronic kidney disease is an important risk factor for death and cardiovascular-related morbidity, but estimates to date of its prevalence in Canada have generally been extrapolated from the prevalence of end-stage renal disease. We used direct measures of kidney function collected from a nationally representative survey population to estimate the prevalence of chronic kidney disease among Canadian adults.We examined data for 3689 adult participants of cycle 1 of the Canadian Health Measures Survey (2007-2009) for the presence of chronic kidney disease. We also calculated the age-standardized prevalence of cardiovascular risk factors by chronic kidney disease group. We cross-tabulated the estimated glomerular filtration rate (eGFR) with albuminuria status.The prevalence of chronic kidney disease during the period 2007-2009 was 12.5%, representing about 3 million Canadian adults. The estimated prevalence of stage 3-5 disease was 3.1% (0.73 million adults) and albuminuria 10.3% (2.4 million adults). The prevalence of diabetes, hypertension and hypertriglyceridemia were all significantly higher among adults with chronic kidney disease than among those without it. The prevalence of albuminuria was high, even among those whose eGFR was 90 mL/min per 1.73 m(2) or greater (10.1%) and those without diabetes or hypertension (9.3%). Awareness of kidney dysfunction among adults with stage 3-5 chronic kidney disease was low (12.0%).The prevalence of kidney dysfunction was substantial in the survey population, including individuals without hypertension or diabetes, conditions most likely to prompt screening for kidney dysfunction. These findings highlight the potential for missed opportunities for early intervention and secondary prevention of chronic kidney disease.