The report provides data from 2014 and shows mortality rates continuing to decrease for dialysis and transplant patients, falling by 32 percent and 44 percent, respectively, since 1996.
Hospitalization rates among end-stage kidney disease patients also decreased to 1.7 admissions per patient per year, compared to 2.1 in 2005, which means a reduction of 19 percent.
Besides these trends, the document notes several current trends in kidney disease in the country, including Medicare spending and statistics on kidney transplants.
Medicare spending for CKD patients older than 65 surpassed the $50 billion threshold, meaning it now represents 20 percent of all Medicare spending for this age group. Overall Medicare spending with paid services for the general population also increased by 3.8 percent in 2014, reaching $435.6 billion. Overall spending for end-stage kidney disease patients accounted for 7.2 percent of that total.
By the end of 2014, the kidney transplant waiting list had increased by 3 percent from 2013 to 88,231 candidates. Of these candidates, 83 percent were waiting for their first transplant. Fewer than 18,000 transplants were performed in 2014, meaning the active kidney transplant waiting list was 2.8 times larger than the national supply of donor kidneys.
“Most recent estimates indicate 14.8 percent of U.S. adults have chronic kidney disease,” Rajiv Saran, MD, professor of internal medicine at the University of Michigan and director of the USRDS coordinating center, said in a press release. “Fortunately, we’ve seen steeper declines in mortality rates in more recent years in this patient population, which is promising.”
The report estimated there were 120,688 new cases of end-stage kidney disease in 2014, representing a 1.1 percent increase compared to the year before. At the end of 2014, there were also 678,383 dialysis and transplant patients receiving treatment for end-stage kidney disease — an increase of 3.5 percent from 2013.
The use of arteriovenous fistula – an artificial vein used to remove and return blood during dialysis – has increased among patients receiving hemodialysis, but the dialysis catheter use has declined during the same period.
“An interesting note on kidney transplants is a relatively recent initiative called kidney paired donation,” Saran said. “The initiative is aimed at increasing the availability of living donor transplants, and in its simplest form is essentially when two living donors do not match with the respective recipients and decide to perform an exchange whereby the donation goes to each other’s compatible recipient. Kidney paired donation transplants have risen sharply in recent years with 552 performed in 2014, representing 10 percent of living donor transplants that year.”
Saran added that earlier diagnoses and treatments could improve patient outcomes in CKD.
“As newly reported cases of end-stage kidney disease continue to happen each year, physicians and patients need to have continued dialogue about the disease and how best to manage it,” Saran said. “We hope this report provides fellow clinicians and researchers with valuable information they can use when discussing the disease with their patients and colleagues.”
This year, the annual report is released by the USRDS coordinating center at the University of Michigan Kidney Epidemiology and Cost Center, in partnership with the Arbor Research Collaborative for Health.