There is good news in the annual data report from the United States Renal Data System, coordinating center based at the University of Michigan Kidney Epidemiology and Cost Center, in partnership with Arbor Research Collaborative for Health.
In the most recent year they have compiled, 2013, the numbers show early deaths among dialysis and kidney transplant dropping by 28 percent and 40 percent, respectively, since 1996.
There is also earlier and better treatment. There were 17,600 kidney transplants performed in 2013 and the active waiting list for kidney transplants is 2.7 times larger than the supply of donor kidneys. Science continues to march toward replacement organs rather than donor stickers and immunosuppressive drugs, but until then management efforts continue to go up. Medicare spending for patients with chronic kidney disease aged 65 and older exceeded $50 billion in 2013 and represented 20 percent of all Medicare spending in that age group. In addition, the total cost to Medicare for end-stage kidney disease grew to $30.9 billion and accounted for 7.1 percent of the overall paid Medicare claims costs.
Home dialysis, where patients have the ability to clear excess fluid and waste from the kidneys by using a dialysis machine in the privacy of their own home, use is 52 percent higher than a decade ago.
There are challenges still. The size of the dialysis population increased 4 percent in 2013, reaching 466,607, 63.2 percent larger than in 2000, and the prevalence of end-stage kidney disease–the last stage of chronic kidney disease when the kidneys can no longer remove waste and excess water from the body, and dialysis or kidney transplantation is necessary for survival– continued to rise.
“Overall trends for end-stage kidney disease are promising for those affected,” says Rajiv Saran, M.D., professor of internal medicine at U-M Health System and director of the USRDS coordinating center. “Patients on dialysis are living longer and equally positive, survival rates have steadily improved among recipients of both living and deceased donor kidney transplants.”
While the report highlights several positive trends, Saran mentions it’s important to also consider areas where improvement is needed.
Those numbers can continue to improve. Several lifestyle-related chronic health conditions, such as diabetes, high blood pressure and other cardiovascular diseases. There remains low awareness of kidney disease in the general population, and rates of screening for the condition by simple urine testing remain low, even among those with risk factors for the disease.