Kidney Disease Research Updates
Winter 2009

NIDDK Report Highlights Rising CKD in United States

A 30 percent increase in chronic kidney disease (CKD) over the past decade has prompted the U.S. Renal Data System (USRDS) to issue for the first time a separate report documenting the magnitude of the disease, which affects an estimated 27 million Americans and accounts for more than 24 percent of Medicare costs. The USRDS is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH).

A major finding of The USRDS 2008 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease is that those with CKD are more likely to die from cardiovascular disease than to reach end-stage renal disease (ESRD). Cardiovascular risk factors, however, can be detected and treated, suggesting those transitioning from CKD to ESRD merit more attention. Expenditures during the transition from CKD to ESRD are considerable, ranging from $14,500 for Medicare patients to $29,000 for those covered by employer group health plans in the month of dialysis initiation.

Using data from multiple sources, the USRDS published the report as a handbook for researchers, Government officials, health program planners, and others to develop research goals, assess public health needs, set program priorities, and inform policymakers and the public. USRDS research depends on collaborations with other agencies of the U.S. Department of Health and Human Services, especially the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, and the Centers for Disease Control and Prevention. Patient registries for other countries also contribute data for analyses.

“These latest data on kidney disease underscore the importance of the research we fund,” said NIDDK Director Griffin P. Rodgers, M.D., M.A.C.P. “With rising rates of chronic and end-stage kidney disease, we need to stimulate research that will help us discover new, effective therapies for these devastating disorders.”

Disease Burden

Volume One of the report defines the disease burden of CKD and examines cardiovascular and other related health problems, rates of adverse health events, preventive care, prescription medication therapies, delivery of care in the transition to ESRD, and the cost to Medicare and employer group health plans.

Volume Two reports that the number of people with ESRD is increasing in size and cost. The incidence of CKD in 2006 was more than 100,000, or 360 per 1 million people, an increase of 3.4 percent since 2005. More than half a million people had ESRD in 2006. Of these people, 70 percent were on dialysis.

Volume Two also explains that in 2006, Medicare paid about $70,000 per dialysis patient. Medicare recipients with ESRD accounted for a little more than 1 percent of the Medicare population and more than 7 percent of program costs. The total cost for ESRD was $33.6 billion. This number includes Medicare spending and all expenditures by other payers, such as employer group health plans.

“NIDDK’s annual analysis and publication of data on kidney disease in the United States is essential in quantifying public health trends, guiding funding priorities, and designing targeted kidney research programs,” said former NIH Director Elias A. Zerhouni, M.D. “The major focus on chronic kidney disease in this year’s report acknowledges that this disorder is a growing public health issue deserving of wider public awareness and intensified scientific investigation.”

The USRDS report is available online at www.usrds.org. For more information about kidney disease, visit the NIDDK’s National Kidney and Urologic Diseases Information Clearinghouse at www.kidney.niddk.nih.gov.

NIH Publication No. 09–4531
March 2009

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