University of Michigan. US: Fewer new cases of end-stage renal disease are being reported in the
United States and mortality rates are declining, indicating that
patients on dialysis or with a kidney transplant are living longer.The trends were revealed by the United States Renal Data System
(USRDS) coordinating center, based at the University of Michigan in
partnership with Arbor Research Collaborative for Health, in its 2014 annual data report on the state of kidney disease in the United States.
Because of an aging and overweight population, end-stage kidney
disease – a condition in which the kidneys lose their ability to remove
excess fluid and waste from the body — and chronic kidney disease are
growing public health issues.
Across the country, 636,905 people are being treated for end-stage
renal disease by dialysis or kidney transplantation, including the
114,813 new patients who were diagnosed with kidney failure in 2012. For
three years in a row, from 2010-2012, the growth rate in the number of
new cases has declined.
“It is too soon to declare victory on the war against the rising tide
of kidney failure, but our analysis provides some good news about
kidney disease in the U.S.,” says kidney specialist Rajiv Saran,
M.D., director of the USRDS coordinating center. “We will follow these
trends closely to see whether they are sustained over the coming years,
study what factors may be responsible for bringing about this positive
change, and explore how it may be even further accelerated.”
Saran is also a professor of internal medicine at the University of Michigan Health System, professor of epidemiology at the U-M School of Public Health and associate director of the University of Michigan’s Kidney Epidemiology and Cost Center.
Total Medicare expenditures for all stages of kidney disease was over
$87 billion in 2012, according to the analysis by the USRDS data
center, not including prescription medications. Most of the cost, about
$58 billion, was spent caring for those with chronic kidney disease.
Nearly 14 percent of the adult population has chronic kidney disease,
a mostly silent disease that can progress to end-stage renal disease,
or kidney failure. Often caused by diabetes and high blood pressure,
others at high risk for CKD are those with a family history of kidney
disease, acute kidney injury, or obesity, as well as adults age 50 and
older and minorities.
“A comprehensive approach to improving kidney health should include
prevention and awareness of chronic kidney disease,” says Saran.
“Warning signs are minimal or non-existent, but simple tests can help
with early diagnosis.”
The USRDS is a national data system that collects, analyzes and distributes information about CKD and ESRD.
Yi Li,
Ph.D., professor of biostatistics at the U-M School of Public Health,
and Bruce Robinson, M.D., vice president of clinical research at Arbor
Research, are co-deputy directors on the project, with cost study led
by University of Michigan School of Public Health faculty Richard Hirth, Ph.D., and Rajesh Balkrishnan, Ph.D. Saran, Li, Hirth and Balkrishnan are all members of the U-M Institute for Healthcare Policy and Innovation.
The analysis was funded in part by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.