Chronic kidney disease (CKD) is a worldwide public health problem. In the United States, the prevalence of end-stage renal disease (ESRD) is increasing . The number of patients enrolled in the ESRD Medicare-funded program has increased from approximately 10,000 beneficiaries in 1973, to 86,354 in 1983, and to 547,982 as of December 31, 2008 .
Although the exact reasons for the growth of the ESRD program are unknown, changes in the demographics of the population, differences in disease burden among racial groups, and under-recognition of earlier stages of CKD and of risk factors for CKD may partially explain this growth [1,3-5].
Patients with ESRD consume a disproportionate share of healthcare resources. The total cost of the ESRD program in the US was approximately $39.46 billion in 2008. Medicare costs per person per year were nearly $66,000 overall, ranging from $26,668 for transplant patients to $77,506 for those receiving hemodialysis therapy .
However, despite the magnitude of the resources committed to the treatment of ESRD and the substantial improvements in the quality of dialysis therapy, these patients continue to experience significant mortality and morbidity and a reduced quality of life.
This topic reviews the epidemiology of CKD and its associated morbidity and mortality. Overviews of the management of CKD and its complications and screening recommendations are discussed separately. (See "Overview of the management of chronic kidney disease in adults".)