Most recent estimates indicate 14.8% of United States adults have
chronic kidney disease. According to an annual data report from the United States Renal Data
System (USRDS), hospitalization and mortality rates for patients with
chronic kidney disease continue to decline in the United States.
Along with those rates, the report highlights several current trends
in kidney disease in the U.S., including Medicare spending in the
patient population and number of kidney transplants.
‘Hospitalization rates among end-stage kidney disease patients decreased to 1.7 admissions per patient per year, as compared to 2.1 in 2005, or a reduction of 19%.’
This year's report provides data from 2014 and is released by the
USRDS coordinating center based at the University of Michigan Kidney
Epidemiology and Cost Center, in partnership with Arbor Research
Collaborative for Health.
The report states that hospitalization rates among end-stage kidney
disease patients decreased to 1.7 admissions per patient per year, as
compared to 2.1 in 2005, or a reduction of 19%. End-stage kidney
disease is the last stage of chronic kidney disease when the kidneys can
no longer remove waste and excess water from the body, and dialysis or
kidney transplantation is necessary for survival.
In addition, mortality rates continue to decrease for dialysis and
transplant patients, falling by 32% and 44%, respectively,
Rajiv Saran, professor of internal
medicine at the University of Michigan and director of the USRDS
coordinating center, said, "Fortunately, we've seen steeper declines in
mortality rates in more recent years in this patient population, which
Other highlights from the report include:
- There were 120,688 newly reported cases of end-stage
kidney disease, representing a slight increase of 1.1% compared
to 2013. At the end of 2014, there were 678,383 dialysis and transplant
patients receiving treatment for end-stage kidney disease, up 3.5% from 2013.
- Among all patients who currently receive
hemodialysis, use of an arteriovenous fistula - a surgically-created vein
used to remove and return blood during dialysis - has increased from 32% to 63% since 2003. Dialysis catheter use has declined
from 27% to 18% during this same time period.
- Medicare spending for beneficiaries ages 65 and older
who have chronic kidney disease exceeded $50 billion, representing 20% of all Medicare spending in this age group. Total Medicare
fee-for-service spending in the general Medicare population increased by
3.8% in 2014 to $435.6 billion, with $32.8 billion, or 7.2%, of that overall spending accounting for end-stage kidney
disease patients. Compared to 2013, the costs of Part D claims and
skilled nursing facility care in 2014 grew at the fastest rates of 21% and 5.5%, respectively.
- Prior to 2013, Medicare spending on hospice care in
end-stage kidney disease patients had been experiencing one of the
highest rates of growth of any category of Medicare spending, but the
spending declined by 6.3% in 2014.
- As of December 31, 2014, the kidney transplant waiting
list increased by 3% over the previous year to 88,231
candidates, of which 83% were awaiting their first kidney
transplant. With less than 18,000 kidney transplants performed in 2014,
the active waiting list was 2.8 times larger than the supply of donor
"An interesting note on kidney transplants is a relatively recent
initiative called kidney paired donation," Saran says. "The initiative
is aimed at increasing the availability of living donor transplants, and
in its simplest form is essentially when two living donors do not match
with the respective recipients and decide to perform an exchange
whereby the donation goes to each other's compatible recipient. Kidney
paired donation transplants have risen sharply in recent years with 552
performed in 2014, representing 10% of living donor transplants
According to Saran, earlier diagnosis and treatment of chronic kidney disease can improve patient outcomes.
"As newly reported cases of end-stage kidney disease continue to
happen each year, physicians and patients need to have continued
dialogue about the disease and how best to manage it," Saran says. "We
hope this report provides fellow clinicians and researchers with
valuable information they can use when discussing the disease with their
patients and colleagues."