ESRD incidence varied widely by state in 2016, with values of ~400 per million and greater in District of Colombia, Indiana, Ohio, Kentucky, Alabama, Louisiana, and Mississippi; and less than 200 per million in Vermont, Alaska, and New Hampshire.
Chart Explanation: Shown is the geographic distribution of ESRD incidence, which has plateaued with varying increases and decreases in total incidence from 2015 to 2016. In 2016, the states with the lowest incidence were New Hampshire (182 per million), Alaska (192 per million), and Vermont (191 per million). States with the highest incidence of ESRD include Indiana (400 per million), Kentucky (401 per million), Alabama (403 per million), Ohio (408 per million), Louisiana (413 per million), and Mississippi (428 per million).
The United States Renal Data System (USRDS) is 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). 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 | Incidence of treated end-stage renal disease (ESRD) (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 | Yes |
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| Regional or National? | National |
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| Demographic Group | Medicare-eligible U.S. citizens with ESRD-related claims with known age, race/ethnicity, and gender |
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| Numerator | Number of patients with new diagnosis of ESRD |
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| Denominator | U.S. resident population from U.S. census from corresponding year |
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| Definition of CKD | Stage 5, <15 ml/min/1.73 m² with Medicare-eligibility for ESRD-related treatment |
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| Primary Data Source Indicator | Number of patients reported to have a new diagnosis of ESRD, as indicated by first treatment (dialysis or functioning transplant) |
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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 | Year, age (from date of birth), race/ethnicity (from Medicare 2728 form), gender (from Medicare 2728 form), assigned cause of ESRD (from Medicare 2728 form), body mass index (BMI) |
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| Limitations of Indicator | Only those who are Medicare-eligible are captured & eligibility may be delayed; changes in 2728 form |
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| Analytic Considerations | Denominators change with missing stratification variables |
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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.