US Renal Data System 2016 Annual Data Report: Epidemiology of Kidney Disease in the United States

Preface

US Renal Data System 2016 Annual Data Report: Epidemiology of

Kidney Disease in the United States

Rajiv Saran, MD, Bruce Robinson, MD, Kevin C. Abbott, MD, Lawrence Y.C. Agodoa, MD,

Patrick Albertus, MPH, John Ayanian, MD, Rajesh Balkrishnan, PhD, Jennifer Bragg-Gresham, PhD,

Jie Cao, MPH, Joline L.T. Chen, MD, Elizabeth Cope, PhD, Sai Dharmarajan, MS, Xue Dietrich, MS,

Ashley Eckard, MS, Paul W. Eggers, PhD, Charles Gaber, MPH, Daniel Gillen, PhD, Debbie Gipson, MD,

Haoyu Gu, PhD, Susan M. Hailpern, MS, Yoshio N. Hall, MD, Yun Han, MS, Kevin He, PhD, Paul Hebert, PhD,

Margaret Helmuth, MA, William Herman, MD, Michael Heung, MD, David Hutton, PhD,

Steven J. Jacobsen, MD, PhD, Nan Ji, MS, Yan Jin, PhD, Kamyar Kalantar-Zadeh, MD, PhD,

Alissa Kapke, MS, Ronit Katz, PhD, Csaba P. Kovesdy, MD, Vivian Kurtz, MPH,

Danielle Lavallee, PharmD, PhD, Yi Li, PhD, Yee Lu, MD, Keith McCullough, MS, Miklos Z. Molnar, MD, PhD,

Maria Montez-Rath, PhD, Hal Morgenstern, PhD, Qiao Mu, MBBS, MPH, Purna Mukhopadhyay, PhD,

Brahmajee Nallamothu, MD, Danh V. Nguyen, PhD, Keith C. Norris, MD, Ann M. O’Hare, MD,

Yoshitsugu Obi, MD, PhD, Jeffrey Pearson, MS, Ronald Pisoni, PhD, Brett Plattner, MD, Friedrich K. Port, MD,

Praveen Potukuchi, MS, Panduranga Rao, MD, Kaitlyn Ratkowiak, MS, Vanessa Ravel, MPH,

Debabrata Ray, MA, MS, Connie M. Rhee, MD, Douglas E. Schaubel, PhD, David T. Selewski, MD,

Sally Shaw, DrPH, Jiaxiao Shi, PhD, Monica Shieu, MPH, John J. Sim, MD, Peter Song, PhD,

Melissa Soohoo, MPH, Diane Stefﬁck, MA, PhD, Elani Streja, PhD, Manjula K. Tamura, MD,

Francesca Tentori, MD, Anca Tilea, MPH, Lan Tong, MS, Megan Turf, BA, Dongyu Wang, MS, Mia Wang, MS,

Kenneth Woodside, MD, April Wyncott, MPH, MBA, Xin Xin, MA, Wei Zeng, MS, Lindsay Zepel, MS,

Sai Zhang, BS, Hui Zho, PhD, Richard A. Hirth, PhD, and Vahakn Shahinian, MD

he US Renal Data System (USRDS) is

the comprehensive national data system that

collects, analyzes, and distributes a broad range of

information about kidney disease in the United States.

It is supported by the Centers for Medicare &

Medicaid Services and the National Institute of

Diabetes and Digestive and Kidney Diseases

(NIDDK) at the National Institutes of Health. The

USRDS Coordinating Center is operated by the

University of Michigan, at the Kidney Epidemiology

and Cost Center (KECC), in partnership with Arbor

Research Collaborative for Health, in Ann Arbor,

Michigan. There are 2 USRDS Special Studies

funded independently by NIDDK: one at the

University of California, Irvine, in collaboration with

the University of Tennessee Health Science Center

and Kaiser Permanente of Southern California,

and the other at the University of Washington, in

collaboration with Stanford University.

In addition to being published as an annual, online

AJKD supplement, and thus accessible via MEDLINE,

the USRDS Annual Data Report remains available at

the USRDS website (www.usrds.org). A summary of

key findings is provided in the introductions to volume

1 (CKD; page S1) and volume 2 (ESRD; page S215)

of the Annual Data Report. We continue further im-

provements to the chapters on vascular access;

expanded coverage of ESRD in the pediatric popula-

tion, including a section on young adults;

and expanded chapters contributed by the 2 Special

Study centers, the ﬁ rst focusing on transition of care

from earlier stages of CKD to ESRD among US vet-

erans and patients within the Kaiser Permanente

Health System of Southern California, and the second

on palliative and end-of-life care among ESRD pa-

tients. The international chapter is further expanded

to include descriptive data from 60 countries.

In the United States, the unadjusted prevalence of

CKD stages 1-5 (not including ESRD) during 2011

through 2014 was estimated at 14.8%, with stage 3

being the most prevalent stage. Awareness of CKD

and screening for the condition in the general popu-

lation remains low. Claims data for patients with

diabetes in the Medicare population indicate that

testing for urine albumin continues to be performed in

fewer than half of such patients. In 2014, even among

patients with a diagnosis of CKD and both diabetes

and hypertension, urine albumin testing was per-

formed for just 48% in the Medicare population.

There were 120,688 new cases of ESRD reported in

2014 (a 1.1% increase compared to 2013). A total of

678,383 individuals were treated for ESRD at the end

of 2014 (up 3.5% from 2013), a number that continues

to rise due to falling mortality rates among those with

ESRD. On a positive note, large net reductions in

Ó 2017 by the National Kidney Foundation, Inc. Published by

0272-6386

http://dx.doi.org/10.1053/j.ajkd.2016.12.004

Am J Kidney Dis. 2017;69(3)(suppl 1):Svii-Sviii Svii

mortality among patients with ESRD or earlier stages

of CKD continue to be observed, as before.

Medicare spending for beneﬁciaries ages 65 and

older who have CKD exceeded $50 billion, repre-

senting 20% of all Medicare spending in this age

group. Medicare fee-for-service spending in the gen-

eral 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 ESRD patients.

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 fewer than 18,000 kidney

transplants performed in 2014, the active waiting list

was 2.8 times larger than the supply of donor kidneys.

ACKNOWLEDGEMENTS

Suggested Citation: Saran R, Robinson B, Abbott KC, et al. US

Renal Data System 2016 Annual Data Report: epidemiology of

kidney disease in the United States. Am J Kidney Dis.

2017;69(3)(suppl 1):S1-S688.

Support: Funding for the USRDS Coordinating Center

is provided under contract to University of Michigan

Kidney Epidemiology and Cost Center (HHSN 27620140001C).

Financial Disclosure: Dr Bragg-Gresham is a consultant for

IMPAQ International. Dr Kalantar-Zadeh has ﬁnancial interests

with the following entities: Abbott, Abbvie, Alexion, Amgen,

Aveo, Astra Zeneca, Fresenius, Haymarket Media Publisher,

Hospira, Keryx, Otsuka, Relypsa, Shire, and Vifor. Dr Kovesdy is

a consultant for Abbott Nutrition, Relypsa, Sanoﬁ-Aventis, ZS

Pharma, and Nephrogenex. Dr Morgenstern is a consultant at

Arbor Research Collaborative for Health. Dr O’Hare received

speaker fees from Henry Ford Hospital System (Greenﬁeld), the

Japanese Society of Dialysis and Transplantation, and the

University of Alabama in 2015. Dr O’Hare also receives honoraria

from UpToDate and from CJASN for her work as an associate

editor. Dr Sim has investigator-initiated research grants

from Keryx Pharmaceuticals, Malinckrodt Pharmaceuticals,

Sanoﬁ Aventis Pharmaceuticals, and Ostuka Pharmaceuticals.

The other authors declare that they have no relevant ﬁnancial

interests.

Saran et al

Sviii Am J Kidney Dis. 2017;69(3)(suppl 1):Svii-Sviii