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Indicator Details — Children and Adolescents: Incident Counts of Children and Adolescents with Treated ESRD by Modalitya,b
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a Adapted from the 2020 USRDS Annual Data Report (United States Renal Data System, 2020).

b As per the release of the 2015 USRDS report, the age range categories will be defined as shown above. Children and adolescents will be defined as individuals with less than or equal to 21 years of age from this point forwards.

About 24% of children and adolescents with incident ESRD initiated treatment with a kidney transplant in 2018, whereas 76% were treated with dialysis.

Chart Explanation: 

In 2018, 1,218 patients aged 21 years or younger began treatment for ESRD in the United States; since 2009 the incident count has decreased for dialysis by 17% overall) and 2% overall increase for transplants. During 2018, 76% of children and adolescents (0- to 21-year-olds) were on dialysis, whereas 24% initiated ESRD therapy with a transplant. 

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, 2020) are publicly available for download.

Description of MeasureIncidence of treated end-stage renal disease (stage 5) in children & adolescents
Type of Data SourcePublic
Health Care System DataNo
Regional or National?National
Demographic GroupMedicare-eligible U.S. citizens <22 years old with ESRD-related claims with known age, race/ethnicity, and gender
NumeratorNumber of patients <22 years old with new diagnosis of ESRD
DenominatorU.S. resident population <22 years old from U.S. census from corresponding year
Definition of CKDStage 5, <15 ml/min per 1.73 m² with Medicare-eligibility for ESRD-related treatment
Primary Data Source IndicatorNumber of patients reported to have a new diagnosis of ESRD, as indicated by first treatment (dialysis or functioning transplant)
Primary Indicator Method of MeasurementClaims
Frequency of Measurement (Primary)Annual (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available


Additional Data Items of InterestYear, age (from date of birth), race/ethnicity (from Medicare 2728 form), gender (from Medicare 2728 form), assigned cause of ESRD (from Medicare 2728 form), BMI
Limitations of IndicatorOnly those who are Medicare-eligible are captured and eligibility may be delayed; changes in 2728 form
Analytic ConsiderationsDenominators change with missing stratification variables
References and Sources:
  • United States Renal Data System. 2020 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, 2020.

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd