Effectiveness: End Stage Renal Disease
2010 National Healthcare Quality and Disparities Reports
Management of End Stage Renal Disease
Adult hemodialysis patients with adequate dialysis
Dialysis patients under age 70 who were registered on a waiting list for transplantation
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure
Ratio of observed deaths to expected deaths among Medicare hemodialysis patients
New end stage renal disease patients who initiated hemodialysis with an arteriovenous fistula
Management of End Stage Renal Disease
Measure Title
Adult hemodialysis patients with adequate dialysis.
Measure Source
University of Michigan Kidney Epidemiology and Cost Center (UMKECC), Dialysis Facility Reports.
National Table
3_1_1.1 Adult hemodialysis patients with adequate dialysis, United States, 2006-2009
National Data Source
UMKECC, Unit Specific Report (USR).
National Denominator
Medicare hemodialysis patients.
National Numerator
Subset of the denominator population with a urea reduction ratio (URR) of 65% or higher.
State Table
3_1_1.2 Adult hemodialysis patients with adequate dialysis, by State, 2000-2008
State Data Source
UMKECC, Unit Specific Report (USR).
State Denominator
Medicare hemodialysis patients.
State Numerator
Subset of the denominator with a URR of 65% or higher.
Comments
Standard errors were calculated based on sample N, not sampling unit; therefore, reported standard errors may be understated.
Management of End Stage Renal Disease
Measure Title
Dialysis patients under age 70 who were registered on a waiting list for transplantation.
Measure Source
Healthy People 2010.
National Tables
3_1_2.1 Dialysis patients under age 70 who were registered on a waiting list for transplantation, United States, 1999-2006
3_1_2.2a-b Dialysis patients under age 70 who were registered on a waiting list for transplantation, United States, 2006, by:
- Race.
- Ethnicity.
National Data Source
National Institutes for Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS).
National Denominator
All incident end stage renal disease (ESRD) Medicare patients in the given year who were under age 70 and had a known residence in the 50 States or DC. Patients who received a transplant at any time from a live donor were excluded from the measure.
National Numerator
Subset of the denominator who were registered on the kidney transplant waiting list on December 31 of the measure year or received a deceased-donor kidney within 1 year of their ESRD initiation date.
State Table
3_1_2.3 Dialysis patients under age 70 who were registered on a waiting list for transplantation, by State, 1999-2006
State Data Source
NIH, NIDDK, USRDS.
State Denominator
Same as National.
State Numerator
Same as National.
Comments
The measure was calculated as the percentage (by Kaplan-Meier methodology) who were either wait-listed or received a deceased-donor kidney within 1 year of their ESRD initiation date.
This measure is referred to as measure 4-5 in Healthy People 2010 documentation.
Management of End Stage Renal Disease
Measure Title
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure.
Measure Source
Healthy People 2010.
National Tables
3_1_3.1 Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure, United States, 1998-2004
3_1_3.2a-b Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure, United States, 2004, by:
- Race.
- Ethnicity.
National Data Source
National Institutes for Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS).
National Denominator
All Medicare dialysis patients who initiated therapy in the given year and had a known residence in the 50 States or DC, excluding patients with prior kidney transplants and patients over the age of 69.
National Numerator
Subset of the denominator receiving a transplant within 3 years of renal failure.
State Table
3_1_3.3 Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure, by State, 2000-2004
State Data Source
NIH, NIDDK, USRDS.
State Denominator
Same as National.
State Numerator
Same as National.
Comments
Note that the Healthy People 2010. measure refers to "within 3 years of registration on a waiting list." Measuring transplants within 3 years of renal failure yields a more complete picture of access to transplantation.
This measure is referred to as measure 4-6 in Healthy People 2010 documentation.
Management of End Stage Renal Disease
Measure Title
Ratio of observed deaths to expected deaths among Medicare hemodialysis patients.
Measure Source
University of Michigan Kidney Epidemiology and Cost Center (UMKECC), Unit Specific Report (USR).
State Table
3_1_4.1 Standardized mortality ratio for dialysis patients, by State, 2000-2008
State Data Source
UMKECC, USR.
State Denominator
Medicare dialysis patients.
State Numerator
Standardized mortality among the denominator population.
Comments
Standardized mortality ratios (SMRs) are used to compare mortality in annual incident populations over successive years of observation. The death rates are high during the first year of treatment, are lower during the second and third years, and rise again after the fourth year.
Note that the Compare measure pertinent to Dialysis Facility, "patient survival rate," is equivalent to the University of Michigan SMR.
Management of End Stage Renal Disease
Measure Title
New end stage renal disease patients who initiated hemodialysis with an arteriovenous fistula.
Measure Source
Centers for Medicare & Medicaid Services (CMS).
National Tables
3_1_5.1 New end stage renal disease patients who initiated hemodialysis with an arteriovenous fistula, United States, 2008-2009, National Data Source CMS.
National Denominator
All incident hemodialysis patients in identified group in designated year.
National Numerator
All patients in the denominator for whom access used on first outpatient dialysis was given as "AVF."
State Tables
3_1_5.2 New end stage renal disease patients who initiated hemodialysis with an arteriovenous fistula, by State, 2008-2009
State Data Source
Centers for Medicare & Medicaid Services (CMS).
State Denominator
Same as National.
State Numerator
Same as National.
5600 Fishers Lane Rockville, MD 20857