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End Stage Renal Disease
End stage renal disease is the permanent failure of the kidneys to excrete waste, concentrate urine, and regulate electrolytes and necessitates lifetime treatment with dialysis or a kidney transplant19. Over 400,000 people in the United States have ESRD, and almost 100,000 new ESRD patients begin treatment with either dialysis or renal transplantation each year20. About one-fifth of ESRD patients die each year; and age-adjusted 5-year survival is 33% for patients receiving dialysis. In 2001, expenditures for ESRD totaled almost $23 billion, nearly two-thirds of which were paid by Medicare. In general, minorities are more likely to develop ESRD and less likely to be treated for ESRD with kidney transplantation21. Adequacy of dialysis is important to the 70% of ESRD patients on dialysis. Racial differences in adequacy of dialysis (urea reduction ratio 65% or higher) have previously been reported22.
Figure 2.3. Hemodialysis patients with adequate dialysis (urea reduction ratio 65% or higher), by race and ethnicity, 2001-2002
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Source: CMS ESRD Clinical Performance Measures Project, 2001-2002.
Reference population: Hemodialysis patients age 18 and older.
Note: For findings related to all ESRD measures, go to Table 2.3a. Available data do not support analysis stratified by SES.
- In both 2001 and 2002, the proportion of adult hemodialysis patients who received adequate dialysis was lower among blacks and higher among Asians compared with whites (Figure 2.3).
- In both years, the proportion of adult hemodialysis patients who received adequate dialysis was similar among Hispanics and non-Hispanic whites.
- The proportion of adult hemodialysis patients who received adequate dialysis did not change significantly from 2000 to 2001 for any racial or ethnic group.