US Renal Data System 2010 Annual Data Report

Preface US Renal Data System 2012 Annual Data Report Allan J. Collins, MD, Robert N. Foley, MB, Charles Herzog, MD, Blanche Chavers, MD, David Gilbertson, PhD, Charles Herzog, MD, Areef Ishani, MD, Kirsten Johansen, MD, Bertram Kasiske, MD, Nancy Kutner, PhD, Jiannong Liu, PhD, Wendy St. Peter, PharmD, Shu Ding, MS, Haifeng Guo, MS, Allyson Kats, MS, Kenneth Lamb, PhD, Shuling Li, MS, Suying Li, PhD, Tricia Roberts, MS, Melissa Skeans, MS, Jon Snyder, PhD, Craig Solid, PhD, Bryn Thompson, BA, Eric Weinhandl, MS, Hui Xiong, MS, Akeem Yusuf, PhD, David Zaun, MS, Cheryl Arko, BA, Shu-Cheng Chen, MS, Frank Daniels, BS, 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 24th US Renal Data System (USRDS) Annual Data Report covers data through 2010, and again examines chronic kidney disease (CKD) in the United States, defining its burden in the general population. In the first section, we offer important data on the impact of CKD, and use the CKD staging system as a predictor of morbidity and mortality. We also compare hospitalization and rehospitalization rates and evaluate adverse events and interventions associated with cardiovascular disease. We also continue to define Medicare Part D prescription drug use, acute kidney injury, and costs associated with CKD. In the second section, we focus on end-stage renal disease (ESRD). In 2010, a total of 116,946 patients started ESRD therapy, and the prevalent population reached 594,374 (including 415,013 dialysis patients); 17,778 transplants were performed, and 179,361 patients had a functioning graft at year’s end. Program expenditures reached $47.5 billion, with $32.9 billion from Medicare (accounting for 6.3% of total Medicare expenditures). Mortality rates have fallen among patients of all vintages, and there is continued progress in first-year dialysis therapy. Expanded data on rehospitalization after a prior dis-

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charge show that 36% of hemodialysis patients are rehospitalized within 30 days of discharge, a number substantially higher than rates found in the general Medicare and CKD populations. We present new information on the major changes in the bundled prospective payment system for dialysis (introduced in January of 2011), looking at providers switching to the new system; at pre- and post-bundle changes in the use of erythropoietin, intravenous iron, and vitamin D; and at changes in hemoglobin levels and trends in transfusion events.

ACKNOWLEDGEMENTS Support: Funding for the USRDS Coordinating Center is provided under contract to the Minneapolis Medical Research Foundation (MMRF; NIH contract HHSN 267 2007 15002C/NO1-DK-75002). Financial Disclosure: Relevant financial interests for contributors to the supplement are listed on page e4.

© 2012 by the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. 0272-6386/$36.00 http://dx.doi.org/10.1053/j.ajkd.2012.11.031

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