A pproximately 19 million Americans older than 20 years have chronic kidney disease, and an additional 435,000 have end-stage renal disease (Table 11). The incidence of end-stage renal disease, with its annual mortality rate of 24 percent, has doubled every decade since 1980.2 Chronic kidney disease is 100 times more prevalent than end-stage renal disease, and its incidence is increasing at an ...