Top 5 Takeaways

1. Significant Increase in ESKD Cases: From 2000 to 2019, the number of incident ESKD cases in the U.S. increased by 41.8%, while the number of prevalent cases nearly doubled.
2. Primary Causes: Diabetes and hypertension were the leading causes of ESKD, with diabetes accounting for 47% and hypertension 29% of new ESKD cases in 2019.
3. Disparities Among Racial/Ethnic Groups: Black, Hispanic, and American Indian or Alaska Native persons are disproportionately affected by ESKD compared to White persons.
4. Impact on Healthcare System: ESKD is a costly condition, with Medicare expenditures for ESKD reaching $37.3 billion in 2019, accounting for 7% of Medicare paid claims costs.
5. Preventive Measures: Effective management of diabetes and hypertension, along with the use of kidney-protective agents, can help prevent ESKD and reduce its incidence.

Original Article Author and Citation

Corresponding Author

Nilka Ríos Burrows, nrios@cdc.gov

Suggested Citation

Burrows NR, Koyama A, Pavkov ME. Reported Cases of End-Stage Kidney Disease — United States, 2000–2019. MMWR Morb Mortal Wkly Rep 2022;71:412–415. DOI: http://dx.doi.org/10.15585/mmwr.mm7111a3

Summary

End-stage kidney disease (ESKD) is a severe condition requiring dialysis or transplantation and often results in premature death. From 2000 to 2019, the number of ESKD cases in the U.S. increased significantly, with diabetes and hypertension being the primary causes. Disparities exist among racial and ethnic groups, with Black, Hispanic, and American Indian or Alaska Native persons being more affected. Effective management of diabetes and hypertension can help prevent ESKD and reduce its incidence, thus alleviating the burden on the healthcare system.

Methods

The study utilized data from the United States Renal Data System (USRDS) from 2000 to 2019. The data included demographic characteristics, the date of first ESKD treatment, and the primary cause of ESKD. The analysis focused on trends in incident and prevalent ESKD cases by age, sex, race/ethnicity, and primary cause.

Discussion

During the study period, the number of ESKD cases increased significantly, with larger increases observed among Asian, Native Hawaiian or other Pacific Islander, and Hispanic persons. Effective management of diabetes and hypertension, along with the use of kidney-protective agents, can help prevent ESKD. The continued increase in ESKD cases will strain the healthcare system and increase costs.

Conclusion

Effective management of diabetes and hypertension is crucial in preventing ESKD and reducing its incidence. Monitoring trends and addressing disparities in ESKD can help stabilize or reverse the increase in ESKD cases, ultimately reducing the burden on the healthcare system.

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