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CKD-6.1 Data Details

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CKD-6.1 Reduce the proportion of persons with chronic kidney disease who have elevated blood pressure

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health and Nutrition Examination Survey
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent (age adjusted—see Comments)
Baseline (Year): 
22.7 (2001–06)
Target: 
17.6
Target-Setting Method: 
Minimal statistical significance
Target-Setting Method Justification: 
Using minimal statistical significance would target a reduction in the measure of about 5 percentage points (rather than about 2 percentage points lower using the 10% improvement method).
Numerator: 

Number of persons aged 18 years and over with chronic kidney disease stages 1–4 with measured high systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure.

Denominator: 

Number of persons aged 18 years and over with chronic kidney disease stages 1–4 who have blood pressure measurements.

Comparable Healthy People 2010 Objective: 
Not applicable
Data Collection Frequency: 
Periodic
Methodology Notes: 

    Chronic kidney disease (CKD) stages 1-4 are defined as a urinary albumin/creatinine ratio (ACR) >30 mg/g (single measurement) or estimated glomerular filtration rate (eGFR) between 15 and 59 ml/min/1.73 m². The eGFR is computed using the Modification of Diet in Renal Disease (MDRD) study equation.

    Adults are defined as having high blood pressure/hypertension if they have a measurement of mean systolic blood pressure (SBP) ≥140 mm Hg or (b) mean diastolic blood pressure (DBP) ≥90 mm Hg.

    Blood pressure is measured by averaging up to 3 blood pressure readings taken during the physical examination in the NHANES mobile examination center. A detailed description of the procedures for blood pressure measurement in the NHANES has been published elsewhere.

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups:

    • Total: 18-44, 45-64, 65+
    • Sex: 18-44, 45-64, 65+
    • Race/Ethnicity: 18-44, 45-64, 65+
    • Educational Attainment: 25-44, 45-64, 65+
    • Family Income (percent poverty threshold): 18-44, 45-64, 65+
    • Country of Birth: 18-44, 45-64, 65+
    • Disability Status: 20-44, 45-64, 65+
    • Health Insurance Status: 18-44, 45-64
    • Marital Status: 20-44, 45-64, 65+
    • Veteran Status: 18-44, 45-64, 65+
    • Obesity Status: 20-44, 45-64, 65+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2015, the measure was changed from the proportion of persons with CKD who have hypertension (including self-reported, and prescription) to the proportion of persons with CKD having uncontrolled hypertension (measured). The rationale for this revision was to have more meaningful and valid estimate as it relates to reducing uncontrolled hypertension and hence improving cardiovascular care in people with CKD. As a result, the baseline was revised from 54.7% (1999-2004) to 22.7% (2001-2006). The target-setting method was also revised from 10 percent improvement to minimal statistical significance and the target was adjusted from 49.2% to 17.6% to reflect the revised baseline.

References

Additional resources about the objective

  1. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130:461-70.