Preface

US Renal Data System 2011 Annual Data Report

Allan J. Collins, MD, Robert N. Foley, MB, Blanche Chavers, MD, David Gilbertson, PhD,
Charles Herzog, MD, Kirsten Johansen, MD, Bertram Kasiske, MD, Nancy Kutner, PhD,
Jiannong Liu, PhD, Wendy St. Peter, PharmD, Haifeng Guo, Sally Gustafson, MS,
Brooke Heubner, MS, Kenneth Lamb, PhD, Shuling Li, MS, Suying Li, PhD, Yi Peng, MS,
Yang Qiu, MS, Tricia Roberts, MS, Melissa Skeans, MS, Jon Snyder, PhD, Craig Solid, MS,
Bryn Thompson, BA, Changchun Wang, MS, Eric Weinhandl, MS, David Zaun, MS,
Cheryl Arko, BA, Shu-Cheng Chen, MS, Frank Daniels, BS, James Ebben, BS, Eric Frazier, BS,
Christopher Hanzlik, BS, Roger Johnson, Daniel Sheets, BS, Xinyue Wang, BA/BS,
Beth Forrest, BBA, Edward Constantini, MA, Susan Everson, PhD, Paul Eggers, PhD, and
Lawrence Agodoa, MD
T
his 23rd US Renal Data System (USRDS) An-
nual Data Report covers data through 2009, and
again includes a section on chronic kidney disease
(CKD) in the United States, dening its burden in the
general population. Using NHANES (National Health
and Nutrition Examination Survey), Medicare, and
employer group health plan data, we look at cardiovas-
cular and other comorbid conditions, adverse events,
preventive care, Medicare Part D prescription drug
use, and associated costs of CKD to Medicare and
employer group health plans. New ndings show
-blocker use is 65% among those with congestive
heart failure and identied CKD. In those with a
history of CKD and an acute myocardial infarction,
use is 72%. Angiotensin-converting enzyme inhibitor
and angiotensin receptor blockers in those with CKD
and congestive heart failure is 47%-57% and 57.4% in
the non-CKD population.
As in recent years, the second section of the report
focuses on end-stage renal disease (ESRD) and the
historical data that were the basis of the rst USRDS
reports. In 2009, 116,395 patients started therapy for
ESRD, and the prevalent population reached 571,414
(including 398,861 dialysis patients); 17,736 trans-
plants were performed, and 172,553 patients had a
functioning graft at years end. Program expenditures
reached $42.5 billion, with $29.0 billion from Medi-
care (accounting for 5.9% of total Medicare expendi-
tures, excluding Part D). The incident rate increased
1.1%, to 355.4 per million. At their rst outpatient
hemodialysis treatment, 65% of patients used only a
catheter and 14% began treatment with an arterio-
venous stula. During 2009, 40% of prevalent dialy-
sis patients had a mean monthly hemoglobin level
within the previous NKF-KDOQI (National Kidney
Foundations Kidney Disease Outcomes Quality Ini-
tiative) target of 11-12 g/dL, and the mean erythropoi-
etin dose per week averaged 18,206 units. First-year
mortality declined by 3%, while morbidity among
hemodialysis patients continued to be a major issue
secondary to increasing rates of hospitalization due to
infection. Rehospitalizations are high, with 38%return-
ing within 30 days after a single hospitalization event.
The public health effect of kidney disease is larger
than previously appreciated, and early detection, edu-
cation, intervention, and risk factor control need to
address the heavy burden of cardiovascular disease
and adverse events in this vulnerable population.
ACKNOWLEDGEMENTS
Suggested Citation: Collins AJ, Foley RN, Chavers B, et al: US
Renal Data System 2011 Annual Data Report. Am J Kidney Dis.
2012;59(1)(suppl 1):e1-e420.
Publications based upon USRDS data reported here or supplied
upon request must include this citation and the following notice:
The data reported here have been supplied by the US Renal Data
System (USRDS). The interpretation and reporting of these data
are the responsibility of the author(s) and in no way should be seen
as an ofcial policy or interpretation of the US government.
Support: Funding for the USRDS Coordinating Center is pro-
vided under contract to the Minneapolis Medical Research Founda-
tion (MMRF; NIH contract HHSN 267 2007 15002C/NO1-DK-7-
5002).
Financial Disclosure: Relevant nancial interests for contribu-
tors to the supplement are listed in the Funding and Chapter
Contributors page of the supplement.
2011by the National Kidney Foundation, Inc. Publishedby Elsevier
Inc. All rights reserved.
0272-6386/$36.00
doi:10.1053/j.ajkd.2011.11.015
Am J Kidney Dis. 2012;59(1)(suppl 1):evii evii