The numbers of ESRD facilities varied widely by state in 2016, with north central and southeastern states generally having the greatest concentration of facilities per resident.
Chart Explanation: In 2016, the number of ESRD facilities per 1,000 ESRD patients varied dramatically by state. Hawaii, New York, and California had the lease facilities per 1,000 ESRD patients (approximately 6-7); whereas South Dakota (17.4), Iowa (14.6), North Dakota (14.3) had the most facilities per 1,000 ESRD patients.
The United States Renal Data System (USRDS) is a national registry of all patients treated for end-stage renal disease (ESRD) in the United States. It is sponsored by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the Centers for Medicare & Medicaid Services (CMS) that reports prevalence of all treated ESRD in the United States. U.S. population denominators are determined through U.S. Census data. Tables from the USRDS annual report (
United States Renal Data System, 2018) are publicly available for download.
| Field | Data |
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| Description of Measure | Dialysis and transplant centers (stage 5) |
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| Data Source | USRDS (NIDDK/CMS) |
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| Type of Data Source | Public |
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| Data Set | USRDS |
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| Health Care System Data | No |
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| Regional or National? | National |
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| Demographic Group | Facilities with Medicare-eligible U.S. citizens with ESRD |
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| Definition of CKD | Stage 5, <15 ml/min per 1.73 m² with Medicare-eligibility for ESRD-related treatment |
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| Primary Data Source Indicator | December 31 point prevalent counts of facilities performing dialysis/transplants |
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| Primary Indicator Method of Measurement | Claims |
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| Frequency of Measurement (Primary) | Annual (cross-sectional) |
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| U.S. Region Covered by Primary Variable | All |
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| Period Currently Available | 2016 |
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| Pending Data | 2017 |
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| Additional Data Items of Interest | Type/ownership of facilities, treatment modalities offered, center staffing |
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| Limitations of Indicator | Only those who are Medicare-eligible are captured & eligibility may be delayed |
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| Analytic Considerations | Point vs. period prevalent counts; census data can be used for population denominator (per U.S. population) |
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References and Sources:
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United States Renal Data System. 2018 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2018.
United States Renal Data System. 2019 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2019.