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Indicator Details — Children and Adolescents: Point Prevalence of Children and Adolescents with Reported ESRD per Milliona,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.

As of December 31, 2018, the adjusted prevalence ESRD among 0- to 21-year-olds in the U.S. increased in 2016-2018 with 111 reported ESRD per million U.S. children and adolescents.

Age-adjusted prevalence was highest in male and in Native Hawaiian/Pacific Islander children and adolescents.

Chart Explanation: 

Prevalence of children and adolescents being treated for ESRD continues to increase in the U.S. Adjustment of prevalence for race/ethnicity and gender show that, overall, 111 per million 0- to 21-year-olds were being treated for ESRD in 2016-2018. The prevalence was highest among 18- to 21-year-olds (230 per million) and lowest among 0- to 4-year olds (42 per million). Male children had higher adjusted prevalence than female children (128 vs. 95 per million), and Native Hawaiian/Pacific Islander children had higher adjusted prevalence of ESRD than White, African-American, Asian, and Native-American children (383 vs. 108, 143, 71, and 78 per million, respectively).

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 MeasurePrevalence of renal replacement therapy [dialysis (stage 5D)] 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
NumeratorDecember 31 point prevalent counts of patients <22 years old reported to have 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 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


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 and eligibility may be delayed
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