High burden, high cost and low awareness of kidney disease in the United States

October 30, 2017

According to an annual data report from the United State Renal Data System, the overall burden of kidney disease remains high in U.S. with the rates of kidney failure requiring dialysis or kidney transplantation ranking among the highest in the world.

The prevalence of earlier stages of chronic kidney disease (CKD), while relatively stable at 14.8 percent, implies that an estimated 30 million American adults have CKD, with millions of others at increased risk. In 2015, 124,111 new cases of end stage renal disease (ESRD) were reported with a total of nearly 500,000 patients receiving dialysis treatment and well over 200,000 living with a kidney transplant. Trends in the prevalence of chronic kidney disease are important for health care policy and planning.

This year's report provides data through 2015 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 cost to care for patients with CKD is also significant. In 2015, the total Medicare spending for beneficiaries with kidney disease was nearly $100 billion. This included over $64 billion in spending for all Medicare beneficiaries who have CKD and another $34 billion for beneficiaries with ESRD.

In sharp contrast to the high burden and cost, is the low awareness about the condition among patients with kidney disease, especially those in stages 1 to 3. This may well relate to low levels of urine testing for protein among those with risk factors for the disease or quite simply the consequence of poor access to care among disadvantaged populations. This represents a major road block in the efforts toward preventing progressive kidney failure with high rates of premature morbidity, mortality, risk of end stage renal disease, and high societal cost.

"Over a third of patients starting dialysis have not had the benefit of being evaluated by a kidney doctor prior to this life changing event," says Rajiv Saran, M.D., professor of internal medicine at the University of Michigan and director of the USRDS coordinating center. "Whereas kidney disease is often silent until late stages, there are missed opportunities to detect it early and implement therapies that can slow kidney disease progression. If we can target individuals with risk factors for disease, we can do a lot to prevent kidney failure and other devastating consequences."

Other important highlights from the report include:
-end-
Authors: In addition to Saran, the report's U-M authors include Bruce Robinson, M.D., Vahakn Shahinian, M.D., John Ayanian, M.D., Nicole Bhave, M.D., Jennifer Bragg-Gresham, Ph.D., Debbie Gipson, M.D., Kevin He, Ph.D., William Herman, M.D., Michael Heung, M.D., Richard A. Hirth, Ph.D., David Hutton, Ph.D., Hal Morgenstern, Ph.D., Zubin Modi, M.D., Brahmajee Nallamothu, M.D., Ronald Pisoni, Ph.D., Panduranga Rao, M.D., Douglas E. Schaubel, Ph.D., David T. Selewski, M.D., and Kenneth J. Woodside, M.D.

Funding: Funding for the project came from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, and the U.S. Department of Health and Human Services, under contract HHSN276201400001C, and the USRDS Coordinating Center Team, which consists of investigators and staff from the University of Michigan Health System, the Kidney Epidemiology and Cost Center, in partnership with Arbor Research Collaborative for Health.

Disclosure: Dr. Hal Morgenstern is a consultant at Arbor Research Collaborative for Health.

Reference: United States Renal Data System. 2017 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, MD, 2017. http://www.usrds.org/adr.aspx

Michigan Medicine - University of Michigan

Related Kidney Disease Articles from Brightsurf:

Waistline matters in kidney disease
Does fat matter in kidney disease? The investigators found that all measures of higher abdominal fat content (including visceral fat, liver fat, or subcutaneous fat) and slower walk times were associated with increased levels of cardiometabolic risk factors in adults with non-dialysis dependent kidney disease.

Reducing urinary protein for patients with rare kidney disease slows kidney decline
New findings show that reducing the amount of protein in the urine of patients with focal segmental glomerulosclerosis can significantly slow declines in kidney function and extend time before patients' kidneys fail.

Antioxidant agent may prevent chronic kidney disease and Parkinson's disease
Researchers from Osaka University developed a novel dietary silicon-based antioxidant agent with renoprotective and neuroprotective effects.

Acute kidney injury and end stage kidney disease in severe COVID-19
Many COVID-19 patients experience hematuria, proteinuria and elevated serum creatinine concentration early in the course of the disease.

Genes tell a story about diabetic kidney disease
Studying Finnish genes leads to unique revelations about the development of a serious complication of diabetes, and informs an ongoing genomic study of a Singaporean cohort as part of Singapore's Diabetes Study in Nephropathy and other Microvascular Complications (DYNAMO).

New study provides insight into chronic kidney disease
Researchers have further analyzed a known signaling pathway they believe brings them one step closer to understanding the complex physiology of patients with chronic kidney disease (CKD), which might provide a path to new treatment options.

Predicting risk of chronic kidney disease
Data from about 5 million people (with and without diabetes) in 28 countries were used to develop equations to help identify people at increased five-year risk of chronic kidney disease, defined as reduced estimated glomerular filtration rate (eGFR).

A healthy diet may help prevent kidney disease
In an analysis of published studies, a healthy dietary pattern was associated with a 30% lower incidence of chronic kidney disease.

Is kidney failure a man's disease?
A new analysis of the ERA-EDTA Registry [1] reveals a striking gender difference in the incidence and prevalence of end-stage renal disease.

Chronic kidney disease: Everyone's concern
850 million people worldwide are affected by kidney disease. This worrying figure was published last June.

Read More: Kidney Disease News and Kidney Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.