Disclosures: Burrows reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

March 18, 2022
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Report shows prevalent ESKD cases across the US nearly doubled since 2000

Disclosures: Burrows reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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A newly released Morbidity and Mortality Weekly Report shows a 41.8% increase in incident end-stage kidney disease cases and an 118.7% increase in prevalent cases across the United States between 2000 and 2019.

During the 20-year period, white men between the ages of 45 and 64 years accounted for most of the reported cases. However, Asian, Native Hawaiian or other Pacific Islander, Hispanic individuals and individuals with ESKD from hypertension accounted for the larger increase in cases.

Infographic showing increase in ESKD
Data derived from Burrows NR, et al. MMWR Morb Mortal Wkly Rep. 2022; doi:10.15585/mmwr.mm7111a3.

While Black, Hispanic and American Indian or Alaska Native individuals are about two to three times as likely to experience ESKD as white individuals, the development in incident and prevalent cases among the American Indian or Alaska Native population was not as great as other populations.

According to the report, the American Indian or Alaska Native population may have avoided an increase in cases due to the kidney disease testing and case management organized by the Indian Health Service and supported by the Special Diabetes Program for Indians. Not only could this program have eliminated potential ESKD cases, but it correlated with an estimated Medicare savings around $520.4 million, according to the report.

“Expansion of these programs to other populations could reduce morbidity and save costs,” Nilka Ríos Burrows, MPH, from the CDC, and colleagues wrote in the report.

Diabetes was the primary cause for most of the incident and prevalent cases, but hypertension led to the largest increase. Therefore, programs and effective management of diabetes and hypertension may prevent ESK and lower the number of cases and costs in the future.

“One of the goals of the Advancing American Kidney Health initiative of the [HHS] is to reduce the number of Americans developing ESKD by 25% by 2030,” Burrows and colleagues wrote in the report. “Effective management of diabetes and hypertension, including kidney disease testing and management as part of diabetes care in at-risk populations, can help prevent ESKD. Monitoring trends and racial or ethnic disparity gaps in ESKD, and tracking other factors such as kidney disease awareness, pre-ESKD care, and risk factor (eg, diabetes or hypertension) control and prevention, will be important to evaluate the success of these interventions.”