The Growing Burden of Kidney Disease

Kidney disease statistics for the United States convey the burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Based on these statistics, researchers can estimate the size of the ESRD population in years to come and gauge the need for resources such as dialysis and transplant clinics to treat the growing ESRD population.

Over time, kidney disease statistics show trends and movement. For example, statistics show which ethnic and age groups and geographical regions have the highest incidence of kidney disease. This demographic information helps direct targeted programs to the people who need them most. Statistics can later help measure progress in preventing and treating kidney disease. With the knowledge provided by statistics, researchers and health care providers can make great gains in the fi ght against kidney disease.

Unless otherwise noted, the following statistics are from the United States Renal Data System’s 2010 Annual Data Report and 2011 Annual Data Report.

 One in 10 American adults,
more than 20 million, have some level of CKD.

Source: Centers for Disease Control and Prevention

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Definitions

chronic kidney disease (CKD): any condition that causes reduced kidney function over a period of time. CKD is present when a patient’s glomerular filtration rate remains below 60 milliliters per minute for more than 3 months or when a patient’s urine albumin-to-creatinine ratio is over 30 milligrams (mg) of albumin for each gram (g) of creatinine (30 mg/g).

end-stage renal disease (ESRD): total and permanent kidney failure. When the kidneys fail, the body retains fl uid. Harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys.

acute kidney injury (AKI): sudden, temporary, and sometimes fatal loss of kidney function

incidence: the number of new cases of a disease in a given time period

prevalence: the number of existing cases of a disease at a given point in time

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CKD Incidence

The incidence of CKD is increasing most rapidly in people ages 65 and older.

The incidence of recognized CKD in people ages 65 and older more than doubled between 2000 and 2008.

The incidence of recognized CKD among 20- to 64-year-olds is less than 0.5 percent.

The National Institute of Diabetes and Digestive and Kidney Diseases

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CKD Prevalence

The prevalence of CKD is growing most rapidly in people ages 60 and older.

Between the 1988–1994 National Health and Nutrition Examination Survey (NHANES) study and the 2003–2006 NHANES study, the prevalence of CKD in people ages 60 and older jumped from 18.8 to 24.5 percent.

During that same period, the prevalence of CKD in people between the ages of 20 and 39 stayed consistently below 0.5 percent.

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ESRD Incident Rate

After rising steadily from 1980 to 2001, the incident rate of ESRD
leveled off.

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ESRD Incident Rates by Race

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ESRD Prevalence and Prevalent Rate

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AKI Incidence

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CKD Co-morbidities

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ESRD Treatment Modality

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Kidney Transplantation

After rising steadily from 1980 to 2006, the annual number of kidney transplants declined in 2007 and 2008.

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ESRD Mortality

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Mortality Rates for Dialysis Patients

After rising from 1980 to 2001, mortality rates for dialysis patients started to fall every year. By 2008, they had returned to early 1980s levels.

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General Graft Survival Rates

The percentage of grafts transplanted in 1980 that survived to 1990 was 25.7. That percentage improved steadily in the following decades, with the survival rate from 1999 to 2009 rising to 44.9.

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Graft Survival Rates by Race

While graft survival is lower in African Americans than in Caucasians, patient survival rates are about equal.

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Patient Survival Rates for Dialysis and Transplant Patients

At 85.5 percent, the 5-year survival rate for transplant patients is more than twice the 35.8 percent survival rate for dialysis patients.

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ESRD Costs

Treating ESRD patients cost the United States over $40 billion in public and private funds in 2009.

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Costs per Patient

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Definition

vascular access: a general term to describe where blood is removed from and returned to the body during HD. A vascular access may be an arteriovenous (AV) fistula, an AV graft, or a catheter. An AV fistula is the preferred type of vascular access because it causes fewer problems with infection and clotting. Catheters have the most problems with infection.

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AV Graft Use among Men and Women

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Catheter Use for Vascular Access

Around 18 percent of dialysis patients use a catheter for their vascular access.

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Acknowledgments

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

Kidney Disease Statistics for the United States

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