Chronic Kidney Disease and Military Service in US Adults, 1999-2018.

Background: Although the management of chronic kidney disease (CKD) has changed considerably in US adults, it is uncertain whether the burden, risk factors, and temporal trends of CKD are similar regarding prior military service.

Methods: This observational study used National Health and Nutrition Examination Survey data to quantify the association between CKD and military service in a generalizable sample of US adults between 1999 and 2018.

Results: The respective frequencies (standard error [SE]) of CKD and military service were 15.2% (0.3) and 11.5% (0.3). The proportion (SE) with CKD was significantly higher among those with prior MS vs the overall population (22.7% [0.7] vs 15.2% [0.3]; P < .001). Within the military service population, the proportion (SE) with CKD differed by era: 1999 to 2002, 18.9% (1.1); 2003 to 2006, 24.9% (1.5); 2007 to 2010, 22.3% (1.5); 2011 to 2014, 24.3% (1.7); and 2015 to 2018, 24.0% (1.8) (P = .02). Following adjustment for age, sex, and race and ethnicity, prior military service was associated (P < .05) with a higher likelihood of CKD (adjusted odds ratio, 1.17; 95% CI 1.06-1.28). Adjusted associations of CKD differed in groups with and without military service for the 40 to 64 years age group, ≥ 65 years age group, female sex, and family poverty (P < .05 vs variable-specific reference category).

Conclusions: Military service is associated with a higher likelihood of CKD in US adults. Risk factors for CKD differed among many subgroups both with and without military service history. Future research is needed to better determine whether military service constitutes a unique risk factor for CKD.