USRDS Report Emphasizes Low Awareness of Kidney Diseases

The annual data report from the United States Renal Data System (USRDS) has revealed some positive trends in the treatment of kidney disease in United States, although limitations remain. The report is released by the USRDS Center based at the University of Michigan Kidney Epidemiology and Cost Center, in joint partnership with Arbor Research Collaborative for Health.

Rajiv Saran, MD, professor of internal medicine at U-M Health System and director of the USRDS Center, in collaboration with his colleagues compiled the report, which touches upon several topics related to the prevalence, costs, and treatment of kidney diseases.

On a positive note, the use of home dialysis has increased in recent years. Home dialysis, offers patients more flexibility and convenience, allowing for an improved quality of life, use in 2013 was 52% higher than a decade ago. Consequently, fewer deaths were reported among dialysis and kidney transplant patients in 2013, dropping by 28% and 40%, respectively, since 1996.

Patients with kidney diseases have been living longer because of better treatment alternatives. However, because they are living longer, the medical costs associated with the disease also increase. Medicare spending for patients aged 65 years and older with chronic kidney disease exceeded $50 billion in 2013. This cost represented 20% of the entire Medicare expense in that age group. The expenses are significantly higher for patients with kidney diseases in the final stage. The expense was $30.9 billion and represented 7.1% of the overall paid Medicare claims costs.

While spending per year was 12.7% higher for blacks than whites in 2013, it still represented a reduction from the 19.6% gap that occurred in 2010.

Prevalence of last-stage kidney disease continues to rise. A patient is said to be in the last stage of chronic kidney disease when the kidneys can no longer remove waste and excess water from the body, and dialysis or kidney transplantation is necessary for survival. The size of the dialysis population increased 4% in 2013 and is now 63.2% larger than in 2000.

The active waiting list for kidney transplants was 2.7 times larger than the supply of donor kidneys, with 17,600 kidney transplants performed in 2013.

“Overall trends for end-stage kidney disease are promising for those affected,” Dr Saran said in a statement. “Patients on dialysis are living longer and equally positive, survival rates have steadily improved among recipients of both living and deceased donor kidney transplants.”

However, he also mentions the limitations in treatment and costs of kidney diseases:

“Several lifestyle-related chronic health conditions, such as diabetes, high blood pressure and other cardiovascular diseases can contribute to kidney disease,” he said. “Monitoring and early treatment of those conditions are key to prevention, and can help patients keep their kidney disease under control.”

The report emphasized the low level of awareness in the general population regarding kidney diseases and how they can be life threatening. The rates of screening for the condition by simple urine testing remain low, even among those with risk factors for the disease.