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Indicator Details: Incidence of Treated End-Stage Renal Disease (ESRD) by Treatmenta
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a Adapted from the 2020 USRDS Annual Data Report (United States Renal Data System, 2020).

In 2018, 131,779 patients initiated treatment for ESRD, 127,925 of whom started on dialysis (3,854 started with a kidney transplant).

ESRD incidence increased by about 102% from 1990 to 2018 and the proportion of the overall incident population starting with a transplant (3%) has remained steady since 1990.

Chart Explanation: 

 In 2018, 131,779 patients initiated treatment for ESRD, 127,925 of whom started on dialysis (3,854 started with a kidney transplant). Shown is the increase in incidence of ESRD patients from 1990 to 2018, by initial treatment of ESRD. The incidence of ESRD increased by about 102% over this time period. Despite the increase in ESRD incidence, the proportion of patients initiating treatment with dialysis (~97%) rather than a transplant, has remained fairly steady since 1990.

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 MeasureIncidence of treated end-stage renal disease (ESRD) (Stage 5)
Type of Data SourcePublic
Health Care System DataYes
Regional or National?National
Demographic GroupMedicare-eligible U.S. citizens with ESRD-related claims with known age, race/ethnicity, and gender
NumeratorNumber of patients with new diagnosis of ESRD
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 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


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), BMI
Limitations of IndicatorOnly those who are Medicare-eligible are captured & eligibility may be delayed; changes in 2728 form
Analytic Considerations

Denominators change with missing stratification variables

Data for Prior Years (1990-1999) were prepared at an earlier time period.

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