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Indicator Details: Prevalence of ESRD by U.S. Statea,b,c
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a Adapted from the 2020 USRDS Annual Data Report (United States Renal Data System, 2020).

b Estimates show the prevalence per million state residents.

c Per million rates are adjusted for age, sex, race and ethnicity. 

ESRD prevalence varied widely by state in 2018, with values of >2,500 per million in the District of Columbia and ≤1,300 per million in Alaska, Vermont, Maine, and New Hampshire.

Chart Explanation: 

ESRD prevalence varied by state. In 2018, the highest prevalence was found in the District of Columbia (>2,500 per million population); 12 other states also had relatively high prevalence, at >2,200 per million population (Alabama, Illinois, Indiana, Louisiana, Michigan, Mississippi, Missouri, New Mexico, Ohio, Pennsylvania, South Dakota, and Wisconsin). 

The states with the lowest prevalence of ESRD were New Hampshire (1,179 per million), Vermont (1,261 per million), and Maine (1,341 per million), and Alaska (1,341 per million).

Many of the U.S. states have shown an increase in prevalence. The Midwest region continues to have the highest prevalence of ESRD, relative to other regions, with most states having >2,200 per million in the population. In addition, the Southwest region continues to have a high prevalence, but with most states having ≤2,100 per million prevalence in the population.

The United States Renal Data System (USRDS) is national registry of all patients treated for end-stage renal disease 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 MeasurePrevalence of end-stage renal disease (ESRD) (Stage 5)
Type of Data SourcePublic
Health Care System DataNo
Regional or National?National
Demographic GroupMedicare-eligible U.S. citizens with ESRD-related claims with known age, race/ethnicity, and gender
NumeratorDecember 31 point prevalent counts of patients reported to have ESRD without loss-to-follow up or recovery of renal function
DenominatorU.S. resident population from U.S. census from corresponding year
Definition of CKDStage 5, <15 ml/min/1.73 m² with Medicare-eligibility for ESRD-related treatment
Primary Data Source IndicatorNumber of U.S. patients reported to have ESRD, as indicated by 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


Pending Data


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)
Limitations of IndicatorOnly those who are Medicare-eligible are captured & eligibility may be delayed
Analytical 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