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

This 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, defining its burden in thegeneral population. Using NHANES (National Healthand Nutrition Examination Survey), Medicare, andemployer group health plan data, we look at cardiovas-cular and other comorbid conditions, adverse events,preventive care, Medicare Part D prescription druguse, and associated costs of CKD to Medicare andemployer group health plans. New findings show�-blocker use is 65% among those with congestiveheart failure and identified CKD. In those with ahistory of CKD and an acute myocardial infarction,use is 72%. Angiotensin-converting enzyme inhibitorand angiotensin receptor blockers in those with CKDand congestive heart failure is 47%-57% and 57.4% inthe non-CKD population.

As in recent years, the second section of the reportfocuses on end-stage renal disease (ESRD) and thehistorical data that were the basis of the first USRDSreports. In 2009, 116,395 patients started therapy forESRD, and the prevalent population reached 571,414(including 398,861 dialysis patients); 17,736 trans-plants were performed, and 172,553 patients had afunctioning graft at year’s end. Program expendituresreached $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 increased1.1%, to 355.4 per million. At their first outpatienthemodialysis treatment, 65% of patients used only acatheter and 14% began treatment with an arterio-venous fistula. During 2009, 40% of prevalent dialy-sis patients had a mean monthly hemoglobin level

within the previous NKF-KDOQI (National Kidney

Am J Kidney Dis. 2012;59(1)(suppl 1):evii

Foundation’s 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-yearmortality declined by 3%, while morbidity amonghemodialysis patients continued to be a major issuesecondary to increasing rates of hospitalization due toinfection. Rehospitalizations are high, with 38% return-ing within 30 days after a single hospitalization event.The public health effect of kidney disease is largerthan previously appreciated, and early detection, edu-cation, intervention, and risk factor control need toaddress the heavy burden of cardiovascular diseaseand adverse events in this vulnerable population.

ACKNOWLEDGEMENTS

Suggested Citation: Collins AJ, Foley RN, Chavers B, et al: USRenal 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 suppliedupon request must include this citation and the following notice:The data reported here have been supplied by the US Renal DataSystem (USRDS). The interpretation and reporting of these dataare the responsibility of the author(s) and in no way should be seenas an official 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 financial interests for contribu-tors to the supplement are listed in the “Funding and ChapterContributors” page of the supplement.

© 2011 by the National Kidney Foundation, Inc. Published by ElsevierInc. All rights reserved.

0272-6386/$36.00

doi:10.1053/j.ajkd.2011.11.015

evii