In 2016, adjusted incidence of ESRD was dramatically higher with increasing age (>1,500 per million for people aged 75+ years compared with 131 per million for people aged 22-44 years). Incidence was greater among males; and Native Hawaiian/Pacific Islanders were more than 9 times more likely than whites to initiate treatment for ESRD, even after adjustment for age and gender.
Diabetes (164 per million population) and hypertension (101 per million population) were, by far, the most common assigned causes of incident ESRD.
Chart Explanation: Shown is the adjusted incidence of ESRD in 2015 in the United States by patient subgroup. As expected, the incidence rose dramatically with age (1,581 per million for people aged 75+ years compared to 129 per million for people aged 22 to 44 years). Incidence was higher in males (by >170 per million) than females. African-Americans were more than 2 times more likely than whites to initiate treatment for ESRD, while Native Hawaiian/Pacific Islanders were more than 9 times more likely than whites, and more than 3 times more likely than Afrian-Americans to initiate treatment for ESRD. Patients with assigned ESRD causes of diabetes and hypertension had the highest incidence.
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, 2018
) are publicly available for download.
|Description of Measure||Incidence of treated end-stage renal disease (ESRD) (stage 5)|
|Data Source||USRDS (NIDDK/CMS)|
|Type of Data Source||Public|
|Health Care System Data||Yes|
|Regional or National?||National|
|Demographic Group||Medicare-eligible U.S. citizens with ESRD-related claims with known age, race/ethnicity, and gender|
|Numerator||Number of patients with new diagnosis of ESRD|
|Denominator||U.S. resident population from U.S. census from corresponding year|
|Definition of CKD||Stage 5, <15 ml/min/1.73 m² with Medicare-eligibility for ESRD-related treatment|
|Primary Data Source Indicator||Number of patients reported to have a new diagnosis of ESRD, as indicated by first treatment (dialysis or functioning transplant)|
|Primary Indicator Method of Measurement||Claims|
|Frequency of Measurement (Primary)||Annual (cross-sectional)|
|U.S. Region Covered by Primary Variable||All|
|Period Currently Available||2016|
|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)|
|Limitations of Indicator||Only those who are Medicare-eligible are captured & eligibility may be delayed; changes in 2728 form|
|Analytic Considerations||Denominators change with missing stratification variables|
|Adjustment||Estimates are adjusted for age, race, and gender, as appropriate, using the 2005 ESRD cohort as reference.|
References and Sources:
United States Renal Data System. 2017 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, 2017.
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.