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Kidney Disease Statistics for the United States

On this page:

The Growing Burden of Kidney Disease

Kidney disease statistics for the United States convey the burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Based on these statistics, researchers can estimate the size of the ESRD population in years to come and gauge the need for resources such as dialysis and transplant clinics to treat the growing ESRD population.

Over time, kidney disease statistics show trends and movement. For example, statistics show which ethnic and age groups and geographical regions have the highest incidence of kidney disease. This demographic information helps direct targeted programs to the people who need them most. Statistics can later help measure progress in preventing and treating kidney disease. With the knowledge provided by statistics, researchers and health care providers can make great gains in the fi ght against kidney disease.

Unless otherwise noted, the following statistics are from the United States Renal Data System’s 2010 Annual Data Report and 2011 Annual Data Report.

 

One in 10 American adults, more than 20 million, have some level of CKD.

Source: Centers for Disease Control and Prevention

 

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Definitions

chronic kidney disease (CKD): any condition that causes reduced kidney function over a period of time. CKD is present when a patient’s glomerular filtration rate remains below 60 milliliters per minute for more than 3 months or when a patient’s urine albumin-to-creatinine ratio is over 30 milligrams (mg) of albumin for each gram (g) of creatinine (30 mg/g).

end-stage renal disease (ESRD): total and permanent kidney failure. When the kidneys fail, the body retains fl uid. Harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys.

acute kidney injury (AKI): sudden, temporary, and sometimes fatal loss of kidney function

incidence: the number of new cases of a disease in a given time period

prevalence: the number of existing cases of a disease at a given point in time

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CKD Incidence

  • The incidence of CKD is increasing most rapidly in people ages 65 and older.
  • The incidence of recognized CKD in people ages 65 and older more than doubled between 2000 and 2008.
  • The incidence of recognized CKD among 20- to 64-year-olds is less than 0.5 percent.

Line graph showing incidence of CKD for age groups 20–64 and 65 and older.

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CKD Prevalence

  • The prevalence of CKD is growing most rapidly in people ages 60 and older.
  • Between the 1988–1994 National Health and Nutrition Examination Survey (NHANES) study and the 2003–2006 NHANES study, the prevalence of CKD in people ages 60 and older jumped from 18.8 to 24.5 percent.
  • During that same period, the prevalence of CKD in people between the ages of 20 and 39 stayed consistently below 0.5 percent.

Bar graph showing percentages of population in age groups 20–29 and 60 and older with stage 3 CKD.

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ESRD Incident Rate

After rising steadily from 1980 to 2001, the incident rate of ESRD leveled off.

Bar graph showing rising incident rates of end-stage renal disease from 1980 to 2009.

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ESRD Incident Rates by Race

  • ESRD incident rates are more than three times higher for African Americans than for Caucasians.
  • After rising from 1980 to 2000, the incident rates for all races stabilized.
  • African American rates rose more quickly than rates for all other races.
  • In 2001, incident rates for American Indians started to decline.

Line graph showing adjusted incident rates of ESRD by race.

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ESRD Prevalence and Prevalent Rate

  • At the end of 2009, more than 871,000 people were being treated for ESRD.
  • Between 1980 and 2009, the prevalent rate for ESRD increased nearly 600 percent, from 290 to 1,738 cases per million.

Bar graph showing adjusted prevalent rates of ESRD from 1980 to 2009.

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AKI Incidence

  • The number of hospitalizations that included an AKI diagnosis rose from 3,942 in 1996 to 23,052 in 2008.
  • The percentage of AKI diagnoses that required dialysis declined from 13.39 in 1996 to 2.25 in 2008.

Line graph showing number of hospitalizations with any AKI diagnosis in 1996, 1999, 2002, 2005, and 2008. Also, a Line graph showing percent of AKI diagnoses requiring dialysis in 1996, 1999, 2002, 2005, and 2008.

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CKD Co-morbidities

  • People with no CKD are more likely than people with stage 3 to 5 CKD to be alive 1 year after a heart attack.
  • The 1-year mortality for heart attack patients without identified CKD is 36 percent, compared with 51 percent for patients with stage 3 to 5 CKD.

Line graph of survival rates among cardiovascular disease patients with and without CKD.

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ESRD Treatment Modality

  • At the end of 2009, 398,861 ESRD patients were being treated with some form of dialysis; 172,553 ESRD patients had a working transplanted kidney.
  • More than 10 times as many ESRD patients receive hemodialysis (HD) treatments at a clinic as those who do peritoneal dialysis (PD) and home HD combined.

Bar graph showing number of patients with a kidney transplant and patients on dialysis.

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Kidney Transplantation

After rising steadily from 1980 to 2006, the annual number of kidney transplants declined in 2007 and 2008.

Line graph showing numbers of deceased donor, living donor, and total kidney transplants.

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ESRD Mortality

  • Though the total number of ESRD patient deaths has continued to rise, the death rate has declined in recent years after peaking in 2001.
  • The number of deaths from ESRD rose from 10,478 in 1980 to 90,118 in 2009.

Bar graph showing mortality rates for ESRD patients from 1980 to 2009. Also, a Line graph showing total number of deaths for ESRD patients from 1980 to 2009.

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Mortality Rates for Dialysis Patients

After rising from 1980 to 2001, mortality rates for dialysis patients started to fall every year. By 2008, they had returned to early 1980s levels.

Bar graph showing death rates for patients on dialysis from 1980 to 2009.

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General Graft Survival Rates

The percentage of grafts transplanted in 1980 that survived to 1990 was 25.7. That percentage improved steadily in the following decades, with the survival rate from 1999 to 2009 rising to 44.9.

Bar graph showing survival rate percentages of graft transplantations over 10 years.

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Graft Survival Rates by Race

While graft survival is lower in African Americans than in Caucasians, patient survival rates are about equal.

Line graph showing graft survival rates for African Americans and Caucasians.

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Patient Survival Rates for Dialysis and Transplant Patients

At 85.5 percent, the 5-year survival rate for transplant patients is more than twice the 35.8 percent survival rate for dialysis patients.

Line graph showing survival rates for dialysis patients and transplant patients.

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ESRD Costs

Treating ESRD patients cost the United States over $40 billion in public and private funds in 2009.

Four pie charts showing Medicare and non-Medicare costs for ESRD in 1998, 2000, 2005, and 2009.

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Costs per Patient

  • ESRD annual expenditures per patient have increased slightly in recent years.
  • From 2006 to 2007, transplant costs per patient decreased but increased again in 2008.
  • Yearly costs for treating a patient on HD are nearly triple the costs for treating a transplant patient.

Bar graph showing annual costs for HD, PD, transplantation, and all ESRD patients from 2006–2009.

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Definition

vascular access: a general term to describe where blood is removed from and returned to the body during HD. A vascular access may be an arteriovenous (AV) fistula, an AV graft, or a catheter. An AV fistula is the preferred type of vascular access because it causes fewer problems with infection and clotting. Catheters have the most problems with infection.

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AV Fistula Use among Men and Women

  • AV fistula use increased from 27.9 to 55.0 percent between 1998 and 2007.
  • AV fistula use increased in both men and women.
  • AV fistula use rates among men were twice as high as among women in the late 1990s.
  • Women have begun to narrow the gap in AV fistula use.

Line graph showing percentages of male, female, and all HD patients with an AV fistula.

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AV Graft Use among Men and Women

  • The decline in AV graft use mirrors the rise in AV fistula use.
  • AV graft use among women is higher than among men.
  • The gap in AV graft use among men and women narrowed gradually between 1998 and 2007.

Line graph showing percentages of male, female, and all HD patients with an AV graft.

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Catheter Use for Vascular Access

Around 18 percent of dialysis patients use a catheter for their vascular access.

Bar graph showing percentages of all HD patients with a catheter from 1998 to 2007.

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Acknowledgments

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

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National Kidney Disease Education Program

3 Kidney Information Way
Bethesda, MD 20892
Phone: 1–866–4–KIDNEY (1–866–454–3639)
TTY: 1–866–569–1162
Fax: 301–402–8182
Email: nkdep@info.niddk.nih.gov
Internet: www.nkdep.nih.gov

The National Kidney Disease Education Program (NKDEP) is an initiative of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services. The NKDEP aims to raise awareness of the seriousness of kidney disease, the importance of testing those at high risk, and the availability of treatment to prevent or slow kidney disease.


National Kidney and Urologic Diseases Information Clearinghouse

3 Information Way
Bethesda, MD 20892–3580
Phone: 1–800–891–5390
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nkudic@info.niddk.nih.gov
Internet: www.kidney.niddk.nih.gov

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.


NIH Publication No. 12–3895
June 2012

Page last updated November 15, 2012

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The National Kidney and Urologic Diseases Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.

National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892–3580
Phone: 1–800–891–5390
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nkudic@info.niddk.nih.gov
Internet: www.kidney.niddk.nih.gov

Department of Health and Human Services The National Institute of Diabetes and Digestive and Kidney Diseases USA.gov is the U.S. government's official web portal to all federal, state, and local government web resources and services. This website is certified by Health On the Net Foundation. Click to verify.

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