The number of full- and part-time dialysis center staff in the United States has shown an increase from 2004-2016. However, approximately 5% of nursing positions remain unfilled, while ~2% of social worker and dietician positions remain unfilled.
Chart Explanation: The numbers of staffing positions continues to grow, although ~5% of nursing positions and ~2% of social worker and dietitian positions remained unfilled in 2016. There were, on average, 14 dialysis patients for each registered nurse in 2016; there were about 100, 63, and 64 patients per licensed vocation and licensed practical nurse, dietitian, and social worker, respectively. There were 10 patients per patient care technician. These patient:staff ratios did not change substantially over the time period 2004 to 2016 (not shown in figure).
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 | Number of full-time and part-time staffing positions at dialysis facilities |
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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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| Analytical 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.