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Indicator Details: Adjusted Prevalence of Treated End Stage Renal Disease (ESRD)a,b
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a Adapted from the 2020 USRDS Annual Data Report (United States Renal Data System, 2020).

b Estimates are adjusted for age, race, and gender, as appropriate, using the 2015 ESRD cohort as reference.

In 2018, the prevalence of treated ESRD increased dramatically with age (1,024 per million in 22-44 years to >7,000 per million in 65-74 years); males had a greater prevalence than females; and Native Hawaiian/Pacific Islanders had a much greater prevalence of treated ESRD compared to all other racial groups. 

Chart Explanation: 

The adjusted 2018 prevalence of ESRD increased dramatically with age, with young adults (22-44 years) having prevalence of approximately 1,024 per million, and older adults (65-74 years) having a prevalence of 7,401.6 per million. People aged 75+ years had a slightly lower prevalence (7,232.5 per million) than people aged 65-74 years, likely because of competing mortality risk with advanced age. Males had higher prevalence (~1,000 per million greater) of ESRD than females. Native Hawaiian/Pacific Islanders had the greatest prevalence of ESRD (approximately 17,600 per million) compared to all other racial groups. ESRD was most common in people with assigned causes of diabetes (884 per million) and hypertension (604 per million). People with glomerulonephritis (347 per million), cystic kidney (117 per million) and other assigned causes (including missing and unknown; <400 per million each) had lower but still substantially high prevalence of ESRD.

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
NumeratorAs of December 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 and eligibility may be delayed
Analytic ConsiderationsDenominators change with missing stratification variables

Estimates are adjusted for age, race, and gender, as appropriate, using the 2015 ESRD cohort as reference.

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