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1. Kidney Disease Statistics
for the United States
National Kidney and Urologic Diseases Information Clearinghouse
The Growing Burden of Kidney Disease
Kidney disease statistics for the United
States convey the burden of chronic
kidney disease (CKD) and end-stage renal
disease (ESRD). Based on these statis­
tics, researchers can estimate the size of
the ESRD population in years to come
and gauge the need for resources such as
dialysis and transplant clinics to treat the
growing ESRD population.
incidence of kidney disease. This demo­
graphic information helps direct targeted
programs to the people who need them
most. Statistics can later help measure
progress in preventing and treating kidney
disease. With the knowledge provided
by statistics, researchers and health care
providers can make great gains in the fight
against kidney disease.
Over time, kidney disease statistics show
trends and movement. For example, sta­
tistics show which ethnic and age groups
and geographical regions have the highest
Unless otherwise noted, the following
statistics are from the United States Renal
Data System’s 2010 Annual Data Report and
2011 Annual Data Report.
Definitions
chronic kidney disease (CKD):
any condition that causes reduced
kidney function over a period of
time. CKD is present when a patient’s
glomerular filtration rate remains below
60 milliliters per minute for more than
3 months or when a patient’s urine
albumin-to-creatinine ratio is over
30 milligrams (mg) of albumin for each
gram (g) of creatinine (30 mg/g).
end-stage renal disease (ESRD): total
and permanent kidney failure. When
the kidneys fail, the body retains fluid.
Harmful wastes build up. A person with
ESRD needs treatment to replace the
work of the failed kidneys.
acute kidney injury (AKI): sudden,
temporary, and sometimes fatal loss of
kidney function
incidence: the number of new cases
of a disease in a given time period
prevalence: the number of existing
cases of a disease at a given point
in time
CKD General Prevalence
One in 10
American adults,
more than
20 million, have
some level of CKD.
Source: Centers for Disease
Control and Prevention

2. CKD Incidence
■
The incidence of CKD is increasing most rapidly in people ages 65 and older.
■
The incidence of recognized CKD in people ages 65 and older more than doubled between 2000
and 2008.
■
The incidence of recognized CKD among 20- to 64-year-olds is less than 0.5 percent.
Percent of Population with
New Cases of CKD, by Age Group
4.5
B
4.0
B
J
3.5
Medicare ages 65+
MarketScan ages 20–64
3.0
Percent
B
B
B
2.5
2.0
B
B
B
B
B
1.5
1.0
0.5
J
J
J
J
J
J
2000
2001
2002
2003
2004
2005
0
J
J
2007
2008
J
2006
Year
*MarketScan represents data from employer group health plans.
CKD Prevalence
■
■
Percent of Population with
Stage 3 CKD, by Age Group
The prevalence of CKD is growing most rapidly
in people ages 60 and older.
30
Between the 1988–1994 National Health and
Nutrition Examination Survey (NHANES)
study and the 2003–2006 NHANES study, the
prevalence of CKD in people ages 60 and older
jumped from 18.8 to 24.5 percent.
During that same period, the prevalence of
CKD in people between the ages of 20 and
39 stayed consistently below 0.5 percent.
Ages 20–39
Ages 60+
25
20
Percent
■
26.0%
24.5%
24.2%
18.8%
15
10
5
0
0.1%
0.3%
NHANES
1988–1994
NHANES
NHANES
NHANES
1999–2002 2003–2006 2001–2008
0.1%
Years
2 | Kidney Disease Statistics for the United States
0.2%

3. ESRD Incident Rate
After rising steadily from 1980 to 2001, the incident rate of ESRD leveled off.
Adjusted Incident Rates of ESRD
400
350
Rate per Million
300
250
200
150
100
50
19
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
0
Year
ESRD Incident Rates by Race
■
ESRD incident rates are more than three times higher for African Americans than for Caucasians.
■
After rising from 1980 to 2000, the incident rates for all races stabilized.
■
African American rates rose more quickly than rates for all other races.
■
In 2001, incident rates for American Indians started to decline.
Adjusted Incident Rates of ESRD by Race
1,200
J
B
F
1,000
All
American Indian
Asian
Caucasian
800
600
J
J
J
J
J
FF
FF
J
J
J J
JJ
FFFFFF
J
JJJJJ JJJJJJ
FFF
FF
FFF
FFFF
JJ
JJ FF
J FFF
HH HHH HH H
JJ
HHHHH
200
F
HHHH
HHH
FF
HHHH
HHHH
HH
400
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
0
19
Rate per Million
H
African American
Year
Kidney Disease Statistics for the United States | 3

4. ESRD Prevalence and Prevalent Rate
■
At the end of 2009, more than 871,000 people were being treated for ESRD.
■
Between 1980 and 2009, the prevalent rate for ESRD increased nearly 600 percent, from 290 to 1,738
cases per million.
Adjusted Prevalent Rates of ESRD
2,000
Rate per Million
1,500
1,000
500
19
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
0
Year
4 | Kidney Disease Statistics for the United States

5. AKI Incidence
■
The number of hospitalizations that included an AKI diagnosis rose from 3,942 in 1996 to 23,052 in
2008.
■
The percentage of AKI diagnoses that required dialysis declined from 13.39 in 1996 to 2.25 in 2008.
Any AKI Diagnosis
25,000
B
B
15,000
10,000
5,000
B
B
B
0
1996
1999
2002
2005
2008
Year
AKI Diagnosis with Dialysis
14
J
12
J
10
Percent
Number of Hospitalizations
20,000
8
J
6
J
4
J
2
0
1996
1999
2002
2005
2008
Year
Kidney Disease Statistics for the United States | 5

6. CKD Co-morbidities
■
People with no CKD are more likely than people with stage 3 to 5 CKD to be alive 1 year after a heart
attack.
■
The 1-year mortality for heart attack patients without identified CKD is 36 percent, compared with
51 percent for patients with stage 3 to 5 CKD.
All-cause Survival in Patients with a First Diagnosis
of Cardiovascular Disease, by CKD Stage, 2007–2008
1.0
B
J
0.9
B
0.8
J
Percent
0.7
B
J
0.6
B
J
B
B
B
B
B
J
B
B
J
B
B
J
J
J
J
J
J
J
0.5
0.4
0.3
B
0.2
J
No CKD
CKD Stage 3–5
0.1
0
0
1
2
3
4
5
6
Months
7
8
ESRD Treatment Modality
■
More than 10 times as many ESRD patients
receive hemodialysis (HD) treatments at a
clinic as those who do peritoneal dialysis (PD)
and home HD combined.
10
12
400,000
350,000
300,000
Dialysis Patients
Other or uncertain
dialysis (1,262)
Continuous cycler-assisted
peritoneal dialysis (18,064)
Continuous ambulatory
peritoneal dialysis (9,458)
Home HD (4,511)
In-center HD (365,566)
250,000
200,000
150,000
100,000
50,000
0
Transplant
Patients
(172,553)
6 | Kidney Disease Statistics for the United States
11
Number of ESRD Patients
by Treatment Modality
At the end of 2009, 398,861 ESRD patients
were being treated with some form of dialysis;
172,553 ESRD patients had a working trans­
planted kidney.
Number of ESRD Patietns
■
9
Dialysis
Patients
(398,861)

7. Kidney Transplantation
After rising steadily from 1980 to 2006, the annual number of kidney transplants declined in 2007
and 2008.
Annual Number of Kidney Transplants
20,000
10,000
J J
5,000
J J J
J J
J
J J
J J
H
H H
H H
H H H
J
H H H H
J J
J J
J
H
H H H H
H
H H H
H
B
Total
Deceased Donor
H
Living Donor
09
08
20
20
06
07
20
05
03
04
20
20
20
20
01
02
20
00
20
99
20
98
19
97
96
19
19
95
94
19
19
19
92
91
93
19
19
90
89
19
19
19
88
0
19
Number
15,000
J J J
J J
Year
Kidney Disease Statistics for the United States | 7

8. ESRD Mortality
■
Though the total number of ESRD patient deaths has continued to rise, the death rate has declined
in recent years after peaking in 2001.
■
The number of deaths from ESRD rose from 10,478 in 1980 to 90,118 in 2009.
Unadjusted Annual Mortality for ESRD Patients
Mortality Rates for ESRD Patients
Number of Deaths per 1,000 Patients, Years at Risk
200
150
100
50
0
1980
1985
1990
1995
2000
2005
2009
Year
Total Patient Deaths for ESRD Patients
100,000
90,000
B
B
Number of Patient Deaths
80,000
B
70,000
60,000
B
50,000
40,000
B
30,000
B
20,000
10,000
B
0
1980
1985
1990
1995
Year
8 | Kidney Disease Statistics for the United States
2000
2005
2009

9. Mortality Rates for Dialysis Patients
After rising from 1980 to 2001, mortality rates for dialysis patients started to fall every year. By
2008, they had returned to early 1980s levels.
Death Rates for Patients on Dialysis
Number of Deaths per 1,000 Patients, Years at Risk
250
200
150
100
50
09
20
08
20
20
07
06
20
20
05
04
20
20
03
02
20
01
20
00
20
95
19
90
19
85
19
19
80
0
Year
General Graft Survival Rates
10-year General Graft Survival Rates
The percentage of grafts transplanted in 1980
that survived to 1990 was 25.7. That percentage improved steadily in the following
decades, with the survival rate from 1999 to
2009 rising to 44.9.
50
40
Percent
30
20
10
19
99
–2
0
09
08
07
19
98
–2
0
6
–2
0
00
19
97
–2
05
–2
0
96
19
95
00
19
–2
0
95
19
90
–1
9
85
19
19
80
–1
9
90
0
Years
Kidney Disease Statistics for the United States | 9

10. Graft Survival Rates by Race
While graft survival is lower in African Americans than in Caucasians, patient survival rates are
about equal.
Graft Survival Rates by Race
100
90
B
J
B
J
80
B
60
Percent
70
J
50
B
40
30
J
20
B
J
African Americans
Caucasians
10
1
99 0 ye
9– a
20 rs
09
)
(1
(2
(2 3 m
00 o
8– nth
20 s
09
)
(2
00 1 y
8– e
20 ar
09
)
00 5 ye
4– a
20 rs
09
)
0
Patient Survival Rates for Dialysis and Transplant Patients
At 85.5 percent, the 5-year survival rate for transplant patients is more than twice the 35.8 percent
survival rate for dialysis patients.
Patient Survival Rates by Dialysis and Transplant
100
J
J
90
80
J
J
B
70
B
Percent
60
B
50
40
B
30
B
Dialysis Patients
20
J
Transplant Patients
10
0
1 year
(2008–2009)
2 years
(2007–2009)
10 | Kidney Disease Statistics for the United States
3 years
(2006–2009)
4 years
(2005–2009)
No data
available
5 years
(2004–2009)

11. ESRD Costs
Treating ESRD patients cost the United States over $40 billion in public and private funds in 2009.
ESRD Costs in Billions
$13.47
$12.04
Total: $16.74
1998
$10.68
$5.53
$4.70
$29.03
$21.31
$13.82
Total: $31.99
2005
Total: $19.35
2000
Non-Medicare Costs
Total: $42.50
2009
Medicare Costs
Costs per Patient
■
ESRD annual expenditures per patient have increased slightly in recent years.
■
From 2006 to 2007, transplant costs per patient decreased but increased again in 2008.
■
Yearly costs for treating a patient on HD are nearly triple the costs for treating a transplant patient.
Annual ESRD Treatment Costs per Patient
for HD, PD, Transplantation (Tx), and all ESRD
$100,000
$90,000
$80,000
$70,000
Cost
$60,000
$50,000
$40,000
$30,000
$20,000
$10,000
0
2006
2007
2008
Year
2009
HD
PD
Tx
All ESRD
Kidney Disease Statistics for the United States | 11

12. Definition
vascular access: a general term to describe where blood is removed from and returned to
the body during HD. A vascular access may be an arteriovenous (AV) fistula, an AV graft, or
a catheter. An AV fistula is the preferred type of vascular access because it causes fewer
problems with infection and clotting. Catheters have the most problems with infection.
AV Fistula Use among Men and Women
■
AV fistula use increased from 27.9 to 55.0 percent between 1998 and 2007.
■
AV fistula use increased in both men and women.
■
AV fistula use rates among men were twice as high as among women in the late 1990s.
■
Women have begun to narrow the gap in AV fistula use.
Percentage of Patients with an AV Fistula
70
B
60
Percent
50
40
30
20
B
B
H
H
J
J
B
H
J
B
H
J
B
B
H
H
J
J
H
H
H
Male
H
H
J
J
J
J
B
10
B
B
B
All
J
Female
0
1998
1999
2000
2001
2002
2003
Year
12 | Kidney Disease Statistics for the United States
2004
2005
2006
2007

13. AV Graft Use among Men and Women
■
The decline in AV graft use mirrors the rise in AV fistula use.
■
AV graft use among women is higher than among men.
■
The gap in AV graft use among men and women narrowed gradually between 1998 and 2007.
Percent of Patients with an AV Graft
70
J
60
H
Percent
50
B
J
H
B
J
H
B
40
J
H
B
J
J
H
H
B
B
30
J
J
H
B
J
H
H
B
B
20
B
10
Male
H
All
J
J
H
B
Female
0
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Year
Kidney Disease Statistics for the United States | 13

14. Catheter Use for Vascular Access
Around 18 percent of dialysis patients use a catheter for their vascular access.
Percent of All Patients with a Catheter
20
Percent
15
10
5
0
1998
1999
2000
2001
2002
2003
Year
14 | Kidney Disease Statistics for the United States
2004
2005
2006
2007

15. Acknowledgments
Publications produced by the Clearinghouse
are carefully reviewed by both NIDDK
scientists and outside experts.
National Kidney Disease
Education Program
3 Kidney Information Way
Bethesda, MD 20892
Phone: 1–866–4–KIDNEY (1–866–454–3639)
TTY: 1–866–569–1162
Fax: 301–402–8182
Email: nkdep@info.niddk.nih.gov
Internet: www.nkdep.nih.gov
The National Kidney Disease Education Pro­
gram (NKDEP) is an initiative of the National
Institute of Diabetes and Digestive and Kidney
Diseases, National Institutes of Health, U.S.
Department of Health and Human Services.
The NKDEP aims to raise awareness of the
seriousness of kidney disease, the importance
of testing those at high risk, and the availability
of treatment to prevent or slow kidney disease.
Kidney Disease Statistics for the United States | 15

16. National Kidney and Urologic
Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892–3580
Phone: 1–800–891–5390
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nkudic@info.niddk.nih.gov
Internet: www.kidney.niddk.nih.gov
The National Kidney and Urologic Diseases
Information Clearinghouse (NKUDIC) is a
service of the National Institute of Diabetes
and Digestive and Kidney Diseases (NIDDK).
The NIDDK is part of the National Institutes
of Health of the U.S. Department of Health
and Human Services. Established in 1987, the
Clearinghouse provides information about
diseases of the kidneys and urologic system to
people with kidney and urologic disorders and
to their families, health care professionals, and
the public. The NKUDIC answers inquiries,
develops and distributes publications, and
works closely with professional and patient
organizations and Government agencies to
coordinate resources about kidney and urologic
diseases.
This publication is not copyrighted. The Clearinghouse
encourages users of this publication to duplicate and
distribute as many copies as desired.
This publication is available at www.kidney.niddk.nih.gov.
U.S. DEPARTMENT OF HEALTH
AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 12–3895
June 2012
The NIDDK prints on recycled paper with bio-based ink.