Chronic kidney disease (CKD) is remarkably common. Globally, about 788 million adults are living with some form of it, which translates to roughly 14.2% of the adult population. In the United States, about 14% of adults have CKD, and the vast majority of early-stage cases go undiagnosed because the condition produces no symptoms until significant damage has occurred.
Global and U.S. Numbers
A 2025 analysis published in The Lancet, covering data through 2023, estimated that nearly 1 in 7 adults worldwide has chronic kidney disease. That 788 million figure has grown steadily over the past three decades, driven largely by rising rates of diabetes and high blood pressure, the two conditions most responsible for kidney damage.
In the U.S., USRDS data from national health surveys puts the adult prevalence at 14.0%, based on markers of reduced kidney function or protein leaking into the urine. That’s tens of millions of Americans. At the most severe end of the spectrum, 831,192 people were living with kidney failure in 2023, an all-time high. These are people who need dialysis or a transplant to survive.
Most Cases Are Mild
CKD is classified into five stages based on how well the kidneys filter waste from the blood. The distribution is heavily weighted toward early stages, which is important context for that 14% number. Among U.S. adults, about 5.1% have stage 3 CKD (a moderate reduction in kidney function), 0.3% have stage 4 (severe reduction), and just 0.2% have stage 5 (kidney failure). The remaining cases fall into stages 1 and 2, where kidney function is still largely preserved but there are signs of damage, usually protein in the urine.
This means the large majority of people counted in CKD statistics have kidneys that still work reasonably well. Many will never progress to kidney failure, especially if the underlying cause is managed. Still, even mild CKD raises the risk of heart disease and other complications, so it’s not something to ignore.
Diabetes and High Blood Pressure Drive Most Cases
The link between kidney disease and these two conditions is striking. About 1 in 3 people with diabetes and 1 in 5 people with high blood pressure have some degree of kidney disease. Breaking that down further by diabetes type: roughly 49% of adults with type 1 diabetes and 41% of adults with type 2 diabetes have CKD. For high blood pressure, about 21% of adults with the condition also have kidney damage.
These numbers matter because diabetes and high blood pressure are themselves extremely common. In the U.S., more than 37 million people have diabetes and nearly half of all adults have high blood pressure. The sheer size of those populations feeds the kidney disease pipeline. Both conditions damage the tiny blood vessels inside the kidneys over years, gradually reducing their ability to filter waste. Controlling blood sugar and blood pressure is the single most effective way to slow or prevent that damage.
Many People Don’t Know They Have It
One of the most important facts about kidney disease is how quietly it develops. The kidneys have enormous reserve capacity. You can lose a significant portion of your kidney function before feeling any symptoms at all. By the time symptoms appear, things like fatigue, swelling in the legs, changes in urination, or persistent nausea, the disease is often advanced.
This is why CKD is sometimes called a “silent” condition. The CDC notes that many adults with diabetes don’t even know their diabetes is present, let alone that it has begun affecting their kidneys. The only way to catch CKD early is through routine blood and urine tests. A simple blood test measures how efficiently your kidneys filter (reported as eGFR), and a urine test checks for protein that healthy kidneys would normally keep in the bloodstream. If you have diabetes, high blood pressure, or a family history of kidney problems, these tests are especially important.
The Financial Scale of the Problem
Kidney disease is one of the most expensive conditions in the U.S. healthcare system. In 2023, Medicare spent $141.1 billion on care for adults with CKD, representing 36% of all Medicare fee-for-service costs. That figure covers only people who haven’t yet reached kidney failure. It doesn’t include the additional billions spent on dialysis and transplantation.
To put that in perspective, just over one quarter of all Medicare fee-for-service spending, $107.9 billion, went to people with CKD who were not yet on dialysis or receiving a transplant. The costs are high because CKD rarely travels alone. It clusters with heart disease, diabetes, and other conditions that require ongoing management, hospitalizations, and medications. People with CKD use far more healthcare resources than people of the same age without it.
Who Is Most at Risk
Several factors raise the odds of developing kidney disease beyond diabetes and high blood pressure. Age is the biggest one. Kidney function naturally declines with age, so CKD prevalence rises sharply after 60. A 70-year-old with mildly reduced kidney function may simply be experiencing normal aging rather than a disease process, which is part of why the overall prevalence number is so high.
Family history of kidney failure increases your risk, as do obesity, smoking, and frequent use of certain over-the-counter pain medications (particularly nonsteroidal anti-inflammatory drugs taken regularly over long periods). Structural problems like recurring kidney infections or kidney stones can also contribute to long-term damage. Black, Hispanic, and Native American populations face higher rates of kidney failure, driven in part by higher rates of diabetes and high blood pressure in those communities, as well as differences in access to early detection and care.
The bottom line: kidney disease is one of the most common chronic conditions in the world, affecting roughly 1 in 7 adults. Most cases are mild, many are preventable, and nearly all are detectable with routine lab work long before symptoms appear.