Fewer new cases of end-stage renal disease are being reported in the United States and mortality rates are declining, indicating that patients on dialysis or with a kidney transplant are living longer.
The trends were revealed by the United States Renal Data System (USRDS) coordinating center, based at the University of Michigan in partnership with Arbor Research Collaborative for Health, in its 2014 annual data report on the state of kidney disease in the United States.
Chronic kidney disease -- a state of kidney damage or reduced kidney function, and in its extreme, end-stage renal disease -- a condition in which the kidneys stop working and cannot remove fluid or waste from the body -- are growing public health issues.
Across the country, 636,905 people are being treated for end-stage renal disease by dialysis or kidney transplantation, including the 114,813 new patients who were diagnosed with kidney failure in 2012. For three years in a row, from 2010-2012, the growth rate in the number of new cases has declined.
"It is too soon to declare victory on the war against the rising tide of kidney failure, but our analysis provides some good news about kidney disease in the U.S.," says kidney specialist Rajiv Saran, M.D., director of the USRDS coordinating center. "We will follow these trends closely to see whether they are sustained over the coming years, study what factors may be responsible for bringing about this positive change, and explore how it may be even further accelerated."
Saran is a professor of internal medicine and professor of epidemiology at the University of Michigan Health System and U-M School of Public Health, and associate director of the University of Michigan's Kidney Epidemiology and Cost Center.
Total Medicare expenditures for all stages of kidney disease was over $87 billion in 2012, according to the analysis by the USRDS data center, not including prescription medications. Most of the cost, about $58 billion, was spent caring for those with chronic kidney disease.
Approximately 10-14 percent of the adult population has chronic kidney disease, a mostly silent disease, yet where the kidneys are damaged or losing effectiveness. The leading causes are diabetes or high blood pressure.
At high risk for CKD are those with diabetes, hypertension, obesity, acute kidney injury, a family history of kidney disease, as well as those age 50 and older and minorities.
"A comprehensive approach to improving kidney health should include raising the level of awareness and efforts at prevention by tackling risk factors early," says Saran. "Simple tests can help with early diagnosis as warning signs may be minimal or non-existent."
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