Although estimates have been adjusted downward in light of the most recent data, researchers still predict sharp increases in the U.S. incidence and prevalence of end-stage renal disease (ESRD) in the years ahead, according to a paper presented at the American Society of Nephrology’s 40th Annual Meeting and Scientific Exposition..
"The expected number of patients with ESRD in 2020 is almost 785,000, which is an increase of over 60 percent compared to 2005," comments Dr. David T. Gilbertson of the U.S. Renal Data System (USRDS) and the Minneapolis Medical Research Foundation, Minneapolis, Minn. Using data available through 2005, the study updates previous estimates based on data through 2000.
The researchers used statistical techniques to project available data on the ESRD population to the year 2020. The model took into account a wide range of factors, including expected trends in population growth and the rising rate of diabetes—the main cause of kidney disease. The study also incorporated the latest data on the risk of progression to ESRD once kidney disease is present.
Based on the results, Dr. Gilbertson and colleagues predict that the U.S. incidence (number of new cases) of ESRD will be about 135,000 in 2015. This figure is about 3,000 lower than the previous estimate. For reasons that are not entirely clear, the incidence of ESRD has been decreasing in recent years, and the updated figure accounts for that trend. The predicted prevalence (total number of cases) of ESRD in 2015 is estimated at 680,000—about 33,000 less than the previous estimate.
Nevertheless, based on a combination of trends—including the aging of the "Baby Boomer" population, rising diabetes rates, and improvements kidney disease treatment allowing better survival—the authors project continued increases in numbers of Americans affected by ESRD. By 2020, the incidence (new cases) of ESRD is expected to rise to 151,000 per year (compared to 107,000 in 2005). Prevalence (all cases) is expected to increase to 785,000 (compared to 485,000 in 2005).
"These projections play an important role in shaping public health policy and health care planning related to the treatment of kidney disease," says Dr. Gilbertson. "Medicare pays for the care for the vast majority of patients with ESRD, with costs approaching $60,000 per year for every patient."
The predictions suggest that, despite recent declines in new cases, policymakers should account for continued increases in the health and economic impact of ESRD in the United States. "While relatively flat ESRD incidence rates may show some progress towards Healthy People 2010 goals of reducing ESRD incidence, it is important to know the expected future counts of patients, as opposed to rates, to inform public health policy and health care planning related to the treatment of kidney disease," Dr. Gilbertson says. "The financial and human resources that will be needed to care for these patients in 2020 will be considerable."
The study abstract, "Projecting the ESRD Population to 2020," (SA-FC046) presented as part of a Free Communications session on the topic of “Epidemiology and Consequences of Chronic Kidney Disease” November 3rd