报告：慢性肾脏疾病在美国

 

Using data from multiple sources, the U.S. Renal Data System (USRDS) has created a new handbook of information that can be used by researchers, government officials, health programme planners, and others to develop research goals, assess public health needs, set programme priorities, and inform policymakers and the public.

One of the major findings central to public health is that those with chronic kidney disease are more likely to die from cardiovascular disease than to reach end-stage kidney disease. However, cardiovascular risk factors can be detected and treated. This suggests that those transitioning from chronic to end-stage kidney disease merit more attention. Expenditures during the transition from chronic to end-stage kidney disease are considerable, ranging from 14,500 U.S. dollars for Medicare patients to 29,000 U.S. dollars for those covered by employer group health plans in the month of dialysis initiation.

The report shows that the number of people with end-stage kidney disease is increasing in size and cost. The incidence of chronic kidney disease in 2006 was more than 100,000, or 360 per one million people, an increase of 3.4 percent over the 2005 incidence rate. There were more than half a million patients with end-stage kidney disease in 2006. Of these, 70 percent were on dialysis.

Medicare paid about 70,000 U.S. dollars per dialysis patient, so the report. Patients with end-stage kidney disease accounted for a little more than one percent of the Medicare population and more than seven percent of Medicare costs. Total cost for end-stage kidney disease was 33.6 billion U.S dollars. This number includes Medicare spending and all expenditures by other payers, such as employer group health plans.

In addition, more than 18,000 kidney transplants were performed in 2006, an increase of 3.5 percent over 2005. Use of deceased donor kidneys increased between 2003 and 2006 at a rate of about six percent to seven percent. Use of living donors fell three percent during that period, but the use of living unrelated donors continues to increase relative to the total number of living donations, and now accounts for 45 percent of all living donor transplantations.