Featured Research

from universities, journals, and other organizations

US Data Highlight Encouraging Trends, 'Staggering' Costs Of End-stage Renal Disease

Date:
August 13, 2007
Source:
American Society of Nephrology
Summary:
Recent progress in the prevention and treatment of end-stage renal disease in the United States give reason for "cautious optimism," but skyrocketing costs are a major concern, according to a new article.

Recent progress in the prevention and treatment of end-stage renal disease (ESRD) in the United States give reason for "cautious optimism," but skyrocketing costs are a major concern, according to a Special Article in the October Journal of the American Society of Nephrology.

Drs. Robert Foley and Allan J. Collins of the United States Renal Data System (USRDS) and University of Minnesota summarize key findings from the 2006 USRDS Annual Data Report. The USRDS update assembles the most recent nationwide data on the incidence, treatment, and outcomes of ESRD— permanent loss of kidney function requiring "renal replacement therapy" (dialysis or kidney transplantation).

"The new update describes successes, failures, and challenges for the future," comments Dr. Foley. "For example, improvements in survival expectations and increased use of fistulas for hemodialysis represent progress. In contrast, ever-increasing numbers of new patients with ESRD tend to suggest that preventive care and health policy practices have been less than optimal."

In 2004, the most recent year for which complete data were available, 104,364 Americans (approximately 0.03 percent of the population) started dialysis or received a kidney transplant. This represented nearly a one percent decline in renal replacement therapy, compared with the previous year.

The decline is especially encouraging at a time when type 2 diabetes mellitus, one of the major risk factors for kidney disease, has reached epidemic proportions. The data suggest that improvements in preventive care may be helping to reduce diabetes-related kidney disease, although several years of new data will be needed to confirm this trend.

Still, diabetes remains the leading cause of ESRD. In particular, rising rates of diabetic ESRD among younger African-American adults suggest "a looming public health crisis," according to the new report. An apparent increase in kidney disease caused by atherosclerosis (narrowing or "hardening" of the arteries) among older adults is another area of concern.

The USRDS data show improvement in several indicators of the quality of dialysis care, including evidence that patients are starting renal replacement therapy at a less-severe stage of kidney disease. The increased use of fistulas for dialysis access reduces problems associated with the use of grafts or catheters. At the same time, there is continued concern about overaggressive use of drugs called erythrocyte-stimulating agents (ESAs) for the treatment of dialysis-related anemia.

Most important, the probabilities of survival for U.S. ESRD patients have improved steadily since the late 1980s—especially remarkable since today's dialysis patients are older and sicker than the dialysis population of 20 years ago. There is some concern that the risk of death during the first year of dialysis has not shown any meaningful improvement since 1993. In contrast, the data show continued reductions in risk of death during the second through fifth years of dialysis.

"While most of these findings are grounds for cautious optimism, the same cannot be said for issues of cost," Drs. Foley and Collins write. With the continued growth of the ESRD population, costs grew by 57 percent between 1999 and 2004. "The cost implications are staggering," Dr. Foley adds. "The most recent estimates showed that Medicare costs for ESRD reached $20.1 billion, while non-Medicare costs rose to $12.4 billion." Costs for the care of ESRD patients now account for 6.7 percent of total Medicare expenditures.

In recent years, the research focus has been on chronic kidney disease (CKD)—loss of kidney function that, in many patients, progresses to ESRD. "The interface between CKD and ESRD, which is very poorly understood, remains an unmet public health challenge," the authors write. Dr. Foley concludes, "If one accepts that healthcare resources are finite, prevention of ESRD has the potential to enhance the lives of people with CKD and without CKD."

The USRDS, funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, is the national data registry that collects, analyzes, and distributes information on the ESRD population in the United States, including treatments and outcomes. The USRDS Coordinating Center is operated by the Minneapolis Medical Research Foundation in Minneapolis, Minnesota. The complete 2006 ESRD update can be accessed on the USRDS website at http://www.usrds.org/adr.htm.

The study entitled, “End-Stage Renal Disease in the United States: An Update from the United States Renal Data System” is available online at http://www.asn-online.org under Media, 2007, and in print in the October issue of the Journal of the American Society of Nephrology (JASN).

The ASN is a not-for-profit organization of 10,000 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of information regarding the latest research and clinical findings on kidney diseases.


Story Source:

The above story is based on materials provided by American Society of Nephrology. Note: Materials may be edited for content and length.


Cite This Page:

American Society of Nephrology. "US Data Highlight Encouraging Trends, 'Staggering' Costs Of End-stage Renal Disease." ScienceDaily. ScienceDaily, 13 August 2007. <www.sciencedaily.com/releases/2007/08/070809111502.htm>.
American Society of Nephrology. (2007, August 13). US Data Highlight Encouraging Trends, 'Staggering' Costs Of End-stage Renal Disease. ScienceDaily. Retrieved August 29, 2014 from www.sciencedaily.com/releases/2007/08/070809111502.htm
American Society of Nephrology. "US Data Highlight Encouraging Trends, 'Staggering' Costs Of End-stage Renal Disease." ScienceDaily. www.sciencedaily.com/releases/2007/08/070809111502.htm (accessed August 29, 2014).

Share This




More Health & Medicine News

Friday, August 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

3 Things To Know About The Ebola Outbreak's Progression

3 Things To Know About The Ebola Outbreak's Progression

Newsy (Aug. 29, 2014) Here are three things you need to know about the deadly Ebola outbreak's progression this week. Video provided by Newsy
Powered by NewsLook.com
Killer Amoeba Found in Louisiana Water System

Killer Amoeba Found in Louisiana Water System

AP (Aug. 28, 2014) State health officials say testing has confirmed the presence of a killer amoeba in a water system serving three St. John the Baptist Parish towns. (Aug. 28) Video provided by AP
Powered by NewsLook.com
Who Could Be Burnt by WHO's E-Cigs Move?

Who Could Be Burnt by WHO's E-Cigs Move?

Reuters - Business Video Online (Aug. 28, 2014) The World Health Organisation has called for the regulation of electronic cigarettes as both tobacco and medical products. Ciara Lee looks at the impact of the move on the tobacco industry. Video provided by Reuters
Powered by NewsLook.com
CDC Director On Ebola Outbreak: 'It's Worse Than I Feared'

CDC Director On Ebola Outbreak: 'It's Worse Than I Feared'

Newsy (Aug. 28, 2014) CDC director Tom Frieden says the Ebola outbreak is even worse than he feared. But he also said there's still hope to contain it. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins