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Indicator Details: Trends in Nephrology Care
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From 2006 to 2015, the percent of Medicare patients under the care of a nephrologist increased significantly for both males and females (P trend<0.001).
Chart Explanation: In 2015, the prevalence of Medicare patients reported seeing a nephrologist prior to ESRD, was around the same for both males (62.5%) and females (63.6%). From 2006 to 2015, the prevalence of nephrology care gradually increased for both genders (9.7% increase for females and 8.7% increase for males) (P trend<0.001).
These results were taken from analyses using the national ESRD population data.

Beginning in June 2005, information related to pre-ESRD care was collected on all new ESRD patients via the Medical Evidence Form (CMS-2728). Timing of pre-ESRD nephrology care, dietitian care, and erythropoietin (EPO) treatment were investigated using national data collected on the form CMS-2728 for 1,106,236 incident ESRD patients between January 1, 2006, and December 31, 2015. A patient was considered under the care of a nephrologist, under the care of a kidney dietitian, or under EPO treatment if their form indicated "Yes" in the check box for the corresponding question. If the box "No" was checked, the patient was classified as none; if the box "Unknown" was checked, the patient was classified as "No." Timing of pre-ESRD care was assigned according to the check box on the form indicating "6–12 months" or ">12 months." If the form indicated treatment but the length of treatment box was left unchecked "<6 months" was assigned.
Description of MeasurePre-ESRD care
Data SourceCenters for Medicare and Medicaid Services Medical Evidence Form (CMS-2728)
Type of Data SourceAdministrative
Health Care System DataNo
Regional or National?National
Demographic GrouopIncident dialysis patients
NumeratorAll individuals in denominator
Denominator1,106,236 ESRD patients incident 1/1/06 and 12/31/15
Definition of diagnosed CKDStage 5 with Medicare-eligibility for ESRD treatment
Primary Data Source IndicatorNephrology care, Dietitian care and Erythropoietin (EPO) treatment prior to ESRD
Primary Indicator Method of MeasurementReported on CMS-2728 form
Secondary (1) VariableDemographics (e.g. age, gender, race/ethnicity), Health (e.g. BMI, diabetes status, dialysis modality), Labs (e.g. serum creatinine, urine albumin, hemoglobin)
Secondary (1) Variable Method of MeasurementAll as reported on CMS 2728 form
Secondary (2) VariableeGFR
Secondary (2) Variable Method of MeasurementCalculated using 4-variable, CKD-EPI equation using data from CMS 2728 form
Frequency of Measurement (Primary)Once
Period Currently Available2015
Additional Data Items of InterestTracking of care immediately prior to ESRD registration began in 2006.
Limitations of IndicatorInformation on the source is unknown.
References and Sources:
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd