Chronic Kidney Disease (CKD) Statistics in US 2026 | CKD Facts

Chronic Kidney Disease in America 2026

Chronic kidney disease is America’s most overlooked public health crisis. The numbers make that claim easy to defend. According to the Centers for Disease Control and Prevention’s most comprehensive national report — Chronic Kidney Disease in the United States, 2023, using data from the 2017–March 2020 National Health and Nutrition Examination Survey (NHANES) and published May 15, 2024 — more than 1 in 7 US adults, approximately 35.5 million people representing 14% of the entire adult population, are estimated to have chronic kidney disease. And of those 35.5 million Americans, the CDC confirms that as many as 9 in 10 do not know they have it. Even among those with the most advanced stages of CKD still short of dialysis — severe CKD Stage 4 — approximately 1 in 3 adults remain unaware of their diagnosis. Kidney disease progresses silently: there are no symptoms in the early stages, no pain, no warning signs that something is wrong. By the time most Americans discover they have CKD, they have often already lost a significant portion of functional kidney tissue — and for a disease with no cure, what is lost cannot be restored.

The clinical definition of CKD matters to understanding these numbers. Under the Kidney Disease: Improving Global Outcomes (KDIGO) 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease — the most recent international clinical standard — CKD is defined by the presence of kidney damage or a reduced estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73m² for more than three months. The KDIGO classification system divides CKD into five stages based on eGFR, with CKD Stage 5 (eGFR <15) representing kidney failure — also called end-stage kidney disease (ESKD) or end-stage renal disease (ESRD) — the point at which dialysis or kidney transplantation is required to sustain life. The NIDDK reports that approximately 2 in every 1,000 Americans are currently living with ESKD. The United States Renal Data System (USRDS) 2023 Annual Data Report — the authoritative federal database on kidney disease outcomes funded by the National Institutes of Health — documents that more than 808,000 Americans were living with ESKD as of the most recent complete data year (2021), with 68% on dialysis and 32% with a functioning kidney transplant. The combined Medicare spending burden from CKD and ESKD reached staggering levels: Medicare spending for CKD patients (not including ESKD) totaled nearly $77 billion in 2021, representing 24.1% of all Medicare spending in the over-65 age group — and the most recent figure from the USRDS 2024 Annual Data Report, cited by the CDC’s Fast Facts on chronic disease spending, shows that nearly 1 in 4 Medicare dollars, totaling $95.7 billion, are now spent on care for CKD patients. Chronic kidney disease in the United States in 2026 is common, devastating, and extraordinarily expensive — and the overwhelming majority of the people who have it don’t know.

Interesting Facts About Chronic Kidney Disease (CKD) in the US 2026

Sources: CDC, “Chronic Kidney Disease in the United States, 2023,” published May 15, 2024, US DHHS/CDC; NIDDK/NIH, “Kidney Disease Statistics for the United States,” updated citing USRDS 2023 ADR, accessed November 2024; United States Renal Data System (USRDS) 2023 Annual Data Report: Epidemiology of Kidney Disease in the United States

Two numbers in the table above define the essential paradox of CKD in the United States in 2026. The first is 35.5 million — a figure so large it exceeds the combined populations of Texas’s five largest cities. The second is 90% — the share of those 35.5 million who have no idea that their kidneys are failing. That gap between disease and awareness is not just a curiosity of renal epidemiology; it is the reason CKD kills so many people who never saw it coming. By the time symptoms appear — fatigue, fluid retention, difficulty concentrating, changes in urine output — kidney function is often already severely compromised. The 9th leading cause of death ranking in the US, assigned to nephritis, nephrotic syndrome, and nephrosis on death certificates, dramatically understates CKD’s true mortality footprint because CKD deaths are far more commonly recorded as cardiovascular deaths — which they are, given that the most common cause of death in CKD patients is heart disease, not kidney failure. Accounting for this, CKD’s true contribution to American mortality is substantially higher than its official rank suggests.

CKD by Age and Sex Statistics in the US in 2026

Sources: CDC, “Chronic Kidney Disease in the United States, 2023,” published May 15, 2024 — all age, sex, and stage prevalence data; NIDDK/NIH, “Kidney Disease Statistics for the United States” — ESKD sex risk ratios from USRDS 2023 ADR; Medscape/NIDDK analysis of NHANES stage-specific CKD trends 2013–2020.

The age gradient in CKD is one of the most pronounced of any chronic disease in the United States. CKD prevalence rises more than fivefold — from 6% in adults aged 18–44 to 34% in adults aged 65 and older — a pattern that reflects the cumulative impact of decades of hypertension, diabetes, and nephrotoxic medication exposure on aging kidneys alongside the natural age-related decline in glomerular filtration rate. At 34%, CKD affects more than 1 in 3 Americans aged 65 and older, which has enormous implications for the Medicare program — the insurer of nearly all Americans in this age group — and helps explain why CKD consumes such a disproportionate share of Medicare spending. Among the 45–64 age group at 12%, CKD prevalence is already twice that of younger adults, and this is the window in which earlier detection through routine screening has the greatest potential to slow progression before irreversible loss of kidney function has occurred. One of the modest encouraging findings in the NHANES trend data is that Stage 3 CKD prevalence declined from 1.6% to 1.3% among adults under 65 between 2013–2016 and 2017–2020, suggesting that better management of diabetes and hypertension may be starting to bend the curve in working-age Americans.

The sex pattern in CKD contains a clinically significant divergence that deserves careful attention. Women have a slightly higher CKD prevalence at 14% versus 12% in men — which aligns with several well-documented biological factors including differences in body size (which affects GFR thresholds), autoimmune kidney diseases more common in women such as lupus nephritis, and hormonal influences on kidney function. But despite having higher CKD prevalence, women are significantly less likely to progress to ESKD: men are 1.6 times more likely to develop ESKD than women. This paradox — more CKD in women, more kidney failure in men — reflects multiple factors: men may progress more rapidly through CKD stages due to higher blood pressure levels, higher rates of non-adherence to treatment, and biological differences in kidney fibrosis pathways. The implication for clinical practice is that both sexes require aggressive CKD management, but the risk profiles and trajectories differ meaningfully.

CKD by Race and Ethnicity Statistics in the US in 2026

Sources: CDC, “Chronic Kidney Disease in the United States, 2023,” published May 15, 2024 — CKD prevalence by race; NIDDK/NIH, “Kidney Disease Statistics for the United States” — all ESKD risk ratios from USRDS 2023 ADR; USRDS 2024 Annual Data Report — ESKD racial/ethnic trends; NIDDK page noting that since 2001 Hispanic

The racial disparities in CKD and ESKD outcomes in the United States represent one of the most severe health inequities in American medicine — and the federal data documents them with precision. Non-Hispanic Black adults have a CKD prevalence of 20% — 8 percentage points higher than non-Hispanic White adults at 12% — and face a risk of progressing to kidney failure that is more than four times greater. The most recent NIDDK statistics, citing the USRDS 2023 ADR, confirm that Black Americans make up approximately 14% of the total US population but account for 30% of all Americans living with ESKD — a twofold overrepresentation in the most severe kidney disease category. The drivers of this disparity are well-documented but complex: they include higher rates of hypertension among Black Americans (itself influenced by systemic socioeconomic and environmental factors as well as genetic predisposition), higher rates of hypertension-caused ESKD relative to diabetes-caused ESKD compared with White and Hispanic patients, and documented differences in access to early nephrology care, transplant evaluation, and RAAS inhibitor prescribing — all of which influence the trajectory from early CKD to kidney failure.

The data on Hispanic Americans facing more than twice the ESKD risk of non-Hispanic White Americans, alongside the fact that Hispanic, Asian, and Native Hawaiian/Pacific Islander ESKD populations have each more than tripled since 2001, reflects the intersection of two converging epidemics: rising obesity and Type 2 diabetes in these communities, and population growth that expands the absolute number of individuals at high CKD risk. The USRDS 2024 Annual Data Report explicitly confirmed that the adjusted incidence of ESKD continued its decade-long decline in 2022 — an 18.6% decrease over the last decade — which is genuinely encouraging and reflects improvements in diabetes management, antihypertensive treatment, and the introduction of SGLT2 inhibitors and GLP-1 receptor agonists, which have demonstrated kidney-protective effects in clinical trials. But this aggregate improvement in ESKD incidence should not obscure the fact that the burden of CKD and ESKD remains profoundly unequal across racial and ethnic lines, and that narrowing those disparities requires targeted screening, access-to-care reform, and culturally competent chronic disease management programs in the communities most affected.

CKD Risk Factors and Causes Statistics in the US in 2026

Sources: CDC, “Chronic Kidney Disease in the United States, 2023,” published May 15, 2024; USRDS 2023 Annual Data Report, NIDDK/NIH, 2023 — Chapter 1 CKD in the General Population (diabetes and hypertension CKD prevalence figures)

Diabetes and hypertension together account for the overwhelming majority of CKD and ESKD cases in American adults, and the statistics quantify how completely these three diseases overlap. The NHANES data through March 2020 shows that 35.6% of adults with diabetes also have CKD — more than one in three — and separately that 24.6% of adults with hypertension have CKD — nearly one in four. Given that diabetes and hypertension are themselves extraordinarily common diseases in the United States — with more than 38 million Americans having diabetes and tens of millions more with hypertension — the pool of Americans at high risk of CKD and ESKD is vast. The CDC CKD factsheet is explicit: “Among adults aged 18 years and older in the United States, diabetes and high blood pressure remain the main causes of ESKD.” Diabetes alone drives approximately 45% of all new ESKD cases each year. One partially encouraging trend in the data: while the overall prevalence of diabetes has increased since 2005 — including rising to 35.6% among CKD patients — the CKD prevalence among diabetics specifically has decreased from 42.3% in 2001–2004 to 38.5% in 2017–2020, suggesting that better diabetes management — including the introduction of kidney-protective medications like SGLT2 inhibitors — may be translating into reduced CKD progression in this high-risk population.

The mortality data documented by the USRDS 2023 ADR is among the most sobering statistics in the entire CKD evidence base. In 2021, Medicare beneficiaries aged 66 and older with CKD died at a rate of 101.8 per 1,000 person-years — more than double the 46.3 per 1,000 rate among Medicare beneficiaries without CKD. This is not the mortality rate of kidney failure specifically; it is the all-cause mortality burden of simply having CKD at any stage, reflecting the dramatically elevated cardiovascular death risk that accompanies even moderate reductions in kidney function. For those who do reach ESKD, the treatment modality profoundly affects survival: adjusted mortality among patients receiving dialysis is 187.7 per 1,000 person-years, compared to 74.3 per 1,000 among kidney transplant recipients — a transplant survival advantage of more than 60%. This is why increasing the rate of kidney transplantation relative to dialysis is one of the explicit goals of the Executive Order on Advancing American Kidney Health signed in 2019, which set targets for expanded home dialysis utilization and preemptive transplantation.

ESKD and Dialysis Statistics in the US in 2026

Sources: NIDDK/NIH, “Kidney Disease Statistics for the United States,” updated citing USRDS 2023 ADR (accessed November 2024); USRDS 2023 Annual Data Report — all ESKD incidence, prevalence, dialysis and mortality data through 2021–22; USRDS 2024 Annual Data Report — 18.6% ESKD incidence decline, 2022 new ESKD cases, dialysis certification data, preemptive transplant rates

The ESKD and dialysis data tells two stories simultaneously — one of progress and one of persistent structural failure in how America treats kidney disease. The progress story: the 18.6% decline in adjusted ESKD incidence over the last decade (USRDS 2024 ADR) is a genuine and clinically meaningful improvement, driven by better management of diabetes and hypertension, the introduction of kidney-protective SGLT2 inhibitors, and improvements in multidisciplinary CKD care. The three-year decline in ESKD prevalence from 2020 to 2022 — the first sustained decline after seventeen consecutive years of increase from 2002 to 2019 — represents a structural shift in the trajectory of the disease, even if COVID-19 mortality among dialysis patients contributed to the 2020 figure. Home dialysis utilization has also increased meaningfully, nearly doubling between 2011 and 2021, consistent with federal policy goals.

But the structural failure story is equally clear. When nearly 97% of the 131,000 Americans newly diagnosed with kidney failure in 2022 began dialysis, and only 3.5% received the superior option of a preemptive kidney transplant, the system is failing at the most critical intervention point in ESKD care. The USRDS 2024 ADR documented that 57.9% of US dialysis clinics were not certified to offer home dialysis, or were certified but had no home patients — a staggering infrastructure gap that directly limits patient choice and access to better care modalities. The survival data makes the stakes concrete: adjusted mortality for transplant recipients (74.3 per 1,000 person-years) is less than 40% of the mortality rate for dialysis patients (187.7 per 1,000 person-years) — transplantation extends life dramatically, yet in 2022 only 28,492 kidney transplants were completed against a waiting list of 90,323 patients. Only about 1 in 4 patients who need a kidney actually receives one in any given year.

Kidney Transplant Statistics in the US in 2026

Sources: US Organ Procurement and Transplantation Network (OPTN), Health Resources and Services Administration (HRSA), transplant data updated October 2024 — 2023 and 2024 transplant counts; NIDDK/NIH, “Kidney Disease Statistics for the United States,” citing USRDS 2023 ADR and OPTN, accessed November 2024 — waiting list figure of 90,323 (November 2024)

The kidney transplant data in the United States in 2026 captures a healthcare system simultaneously improving and insufficient. On the positive side, 2024 was a record year for kidney transplantation, with 28,492 completed transplants — up from 27,332 in 2023 — and the preemptive transplant rate for new ESKD patients rose from 2.3% in 2015 to 3.5% in 2022, showing gradual improvement in the share of patients receiving the best possible outcome before dialysis is even initiated. Children with ESKD have notably favorable transplant access: 85.4% of patients aged 17 and younger who were waitlisted in 2016 received a transplant within five years — a much higher rate than adults — reflecting both the prioritization of younger patients and the stronger physiological rationale for transplantation in pediatric patients. The finding that Black Americans’ 5-year transplant receipt rate (47.7%) is now comparable to White Americans’ (47.4%) is an important improvement from historical patterns in which racial disparities in transplant access were more pronounced.

The insufficiency side of the ledger remains stark. Against a waiting list of 90,323 patients in November 2024, only 28,492 received a kidney transplant — meaning roughly 61,000 patients on the waiting list received no kidney in 2024 alone. At this transplant rate, fewer than 1 in 3 people on the waiting list will receive a kidney in any given year. The shortage of donor kidneys — both living and deceased — is the fundamental bottleneck, and it has no easy solution: deceased donor rates in the United States, while among the highest in the world, cannot keep pace with the ESKD population that continues to grow in absolute terms even as incidence rates decline. The USRDS 2023 ADR noted that “of patients with ESKD who were initially waitlisted for a kidney transplant in 2016, nearly half (46.3%) received a kidney transplant by the end of 5 years” — which means that more than half of all patients on the waiting list in 2016 had not received a transplant after five full years. Many died waiting.

CKD Economic Burden Statistics in the US in 2026

Sources: NIDDK/NIH, “Kidney Disease Statistics for the United States,” citing USRDS 2023 ADR — $77 billion (ages 66+), per-person spending of $28,162 vs. $13,604, ESKD $52.3 billion; National Kidney Foundation Fact Sheet, August 2024, citing USRDS 2023 ADR Chapter 6 — $86.1 billion total Medicare FFS figure; CDC, “Fast Facts: Health and Economic Costs of Chronic Conditions,” citing USRDS 2024 ADR — $95.7 billion

The economic burden of chronic kidney disease in the United States is among the largest of any single disease in the federal healthcare system — and it continues to grow as both the CKD population ages and treatment becomes more intensive. The most striking single figure in the current data comes from the USRDS 2024 Annual Data Report, cited by the CDC’s Fast Facts on chronic disease costs: nearly 1 in 4 Medicare dollars — $95.7 billion in total — are now spent on care for patients with CKD. To put this in context: CKD, which affects approximately 14% of US adults, commands 25% of all Medicare spending. This disproportionality reflects the extraordinary medical intensity of managing CKD patients’ multiple comorbidities — cardiovascular disease, diabetes, anemia, metabolic bone disease, and infection — as well as the sheer cost of dialysis and transplantation for those who progress to kidney failure. Medicare ESKD spending added another $52.3 billion on top of the CKD total in 2021, meaning that in that year alone, kidney disease across all stages cost the Medicare program well over $138 billion combined.

The per-person spending data documented in the USRDS 2023 ADR is equally revealing about the individual-level economic burden: Medicare beneficiaries aged 66 and older with CKD cost $28,162 per person per year in 2021, compared to $13,604 for those without CKD — a differential of more than $14,500 per person annually, entirely attributable to the presence of CKD. For commercially insured patients, the cost escalation is even more severe at advanced stages: patients with Stage 4–5 CKD incurred mean annualized all-cause costs of $76,969 in a study using commercial insurance data — more than 10 times the $7,537 annual cost for patients without CKD — and ESKD patients reached $121,948 in mean annual costs. The USRDS 2022 ADR documented that the total increase in Medicare CKD spending from 2010 to 2019 was approximately 67% among beneficiaries aged 66 and older — driven primarily by the expanding CKD population rather than per-capita cost increases. The implication is clear: without more effective prevention of CKD onset and progression, the fiscal trajectory of this disease within the Medicare program is unsustainable.

Disclaimer: The data reports published on The Global Files are sourced from publicly available materials considered reliable. While efforts are made to ensure accuracy, no guarantees are provided regarding completeness or reliability. The Global Files is not liable for any errors, omissions, or damages resulting from the use of these reports.