United States Renal Data System 2008 Annual Data Report Abstract

VOL 53, NO 1, SUPPL 1, JANUARY 2009

United States Renal Data System 2008 Annual Data Report Abstract Allan J. Collins, MD, Robert N. Foley, MB, Charles Herzog, MD, Blanche Chavers, MD, David Gilbertson, PhD, Areef Ishani, MD, MS, Bertram Kasiske, MD, Jiannong Liu, PhD, Lih-Wen Mau, PhD, Marshall McBean, MD, MSc, Anne Murray, MD, MSc, Wendy St. Peter, PharmD, Haifeng Guo, MS, Qi Li, MS, Shuling Li, MS, Suying Li, MS, Yi Peng, MS, Yang Qiu, MS, Tricia Roberts, MS, Melissa Skeans, MS, Jon Snyder, PhD, Craig Solid, MS, Changchun Wang, MS, Eric Weinhandl, MS, David Zaun, MS, Cheryl Arko, BA, Shu-Cheng Chen, MS, Frederick Dalleska, MS, Frank Daniels, BS, Stephan Dunning, BA, James Ebben, BS, Eric Frazier, BS, Christopher Hanzlik, BS, Roger Johnson, Daniel Sheets, BS, Xinyue Wang, BA/BS, Beth Forrest, BBA, Edward Constantini, MA, Susan Everson, PhD, Paul Eggers, PhD, and Lawrence Agodoa, MD

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his 20th Annual Data Report reports data through 2006. This year we present a new volume on chronic kidney disease (CKD) in the United States, estimating the population using National Health and Nutrition Examination Surveys. We also use diagnostic codes and laboratory data to estimate the population within employer group health plans, assess use of the new International Classification of Diseases, Ninth Revision, Clinical Modification CKD diagnosis codes, and report on morbidity, mortality, care during the transition to endstage renal disease, and expenditures in patients with CKD. In 2006, a total of 110,854 patients started end-stage renal disease therapy, with the prevalent population reaching 506,256; a total of 18,052 transplantations were performed; and 151,502 patients had functioning grafts at year end. Program expenditures reached $33.5 billion, with $22.7 billion from Medicare accounting for 6.4% of total Medicare expenditures. The incident rate increased 3.4% to 360 per © 2008 by the National Kidney Foundation, Inc. 0272-6386/08/5301-0101$36.00/0 doi:10.1053/j.ajkd.2008.10.005 vi

million—the highest in 5 years. Treatment targets are now reached by 93% of hemodialysis patients. Fistula use is 45.4% in prevalent patients, with attempted placements doubling since 1996. Catheter use continues to be a concern. Hemoglobin levels greater than 12 g/dL are common, particularly in some providers. First-year mortality rates for incident hemodialysis patients have decreased for the first time in 11 years; however, pediatric patient survival has not improved. The rate of infectious hospitalizations in the first year of dialysis therapy now equals that of cardiovascular hospitalizations. The public health impact of kidney disease is larger than previously appreciated, and early detection, education, intervention, and risk-factor control are needed to address the heavy burden of cardiovascular disease and adverse events in this vulnerable population.

SUGGESTED CITATION Collins AJ, Foley RN, Herzog C, et al: Excerpts from the United States Renal Data System 2008 Annual Data Report. Am J Kidney Dis 53:S1-S374, 2009 (suppl 1). Publications based upon US Renal Data System data reported here

American Journal of Kidney Diseases, Vol 53, No 1, Suppl 1 (January), 2009: pp vi-vii

Preface

or supplied upon request must include this citation and the following notice: The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.

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ACKNOWLEDGEMENTS The staff at the USRDS Coordinating Center is again grateful to the publishers of the American Journal of Kidney Diseases for the opportunity to present the Annual Data Report. Funding for the USRDS Coordinating Center is provided under contract to the Minneapolis Medical Research Foundation (MMRF; National Institutes of Health contract HHSN 267 2007 15002C/NO1-DK-7-5002).