CKD Places Significant Burden on Patients and Caregivers in the US, Highlights Study

A new systematic literature review is highlighting the substantial economic, emotional, and quality-of-life impacts experienced not only by individuals living with chronic kidney disease (CKD) but also by the informal caregivers who support them.¹

The review, published in BMC Nephrology, underscored the wide-ranging impact of CKD across multiple aspects of life, from financial stability and work productivity to emotional well-being for both patients and caregivers. The group of researchers evaluated studies published between 2016 and 2025 and synthesized evidence from more than 10,000 screened citations to provide a clearer picture of how CKD affects everyday life for those managing the disease.

CKD is one of the most common chronic diseases globally and continues to increase in prevalence. In the United States alone, an estimated 35.5 million adults—roughly 1 in 7 people—are living with CKD.² Patients face elevated risks of cardiovascular disease, kidney failure, and premature death, and the condition contributes to approximately 85,000 deaths annually in the country.

Beyond its clinical consequences, CKD imposes considerable financial strain, though the researchers noted that economic burden data were limited. According to the literature that did report on economic burden, adults with CKD face substantial out-of-pocket medical expenses. Across several studies using national health expenditure data, annual patient out-of-pocket costs averaged approximately $2000. In some cases, medical spending exceeded 10% of household income, particularly among uninsured or publicly insured individuals. Financial hardship was common, with nearly half of non-elderly adults with CKD reporting difficulty paying medical bills.

Quality of life is similarly affected. Many studies in the review evaluated health-related quality of life (HRQOL) using disease-specific assessment tools such as the Kidney Disease Quality of Life-36 (KDQOL-36) survey. Results consistently demonstrated that CKD negatively impacts physical functioning, mental health, and daily activities. Importantly, these impacts tend to worsen as the disease progresses to more advanced stages or when patients have additional conditions such as diabetes.

The QOL burden explored by the study extended past just patients, also exploring the impact on caregivers, who play a critical role in supporting patients with CKD, assisting with daily activities, medical management, and emotional support.

The review found that caregivers frequently devote significant time to supporting patients with CKD, averaging between 27 and 38 hours per week in some studies. Caregiving responsibilities often last several years, with average durations of approximately 4 years.

“None of the included publications reported direct costs to caregivers associated with caring for adults with CKD, such as OOP costs paid by the caregiver,” noted the researchers, highlighting the limited data available on impact of CKD on caregivers. “Nonetheless, studies included in this review described an extensive time commitment, substantial impacts to productivity, and the high level of burden experienced by caregivers.”

Studies included in the review documented notable rates of depression and anxiety among caregivers, as well as moderate to high levels of caregiving burden measured using standardized scales. In one analysis, nearly 60% of caregivers experienced severe or very severe caregiving burden.

The review also underscored the significant impacts of the disease on work productivity. Studies included in the review found that CKD-related symptoms and complications can lead to notable reductions in both work attendance and job performance. Among employed individuals, work productivity losses ranged from approximately 16% to nearly 45%. Many patients reported making major employment decisions because of their illness, including reducing work hours, taking extended leave, retiring early, or leaving the workforce altogether.

Similar to patients, caregivers reported reduced productivity at work, increased absenteeism, and changes in employment such as reducing hours or taking leave to manage caregiving responsibilities. In some cases, caregivers experienced reductions in work productivity exceeding 40%.

The researchers noted several other limitations of their analysis, including a small number of studies included per outcome of interest and varying assessments of outcomes across studies.

References:

1. Osenenko KM, Chatterjee S, Szabo SM, Donato BM. Impact of chronic kidney disease on adults and their caregivers in the United States: a systematic literature review. BMC Nephrol. Published online March 2, 2026. doi:10.1186/s12882-026-04847-8
2. Kidney disease statistics for the United States. National Institute of Diabetes and Digestive and Kidney Diseases. Last updated September 2024. Accessed March 9, 2026. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease