# Presentation: 535377

## Healthy People 2010 Focus Area 4:Chronic Kidney DiseaseProgress ReviewSeptember 21, 2006

## Status of Chronic Kidney Disease Objectives

- 4-2.   Cardiovascular disease deaths in persons with chronic 	  kidney failure
- 4-3.   Counseling for chronic kidney failure care
- 4-4.   Use of arteriovenous fistulas
- 4-5.   Registration for kidney transplantation
- 4-6.   Waiting time for kidney transplantation
- 4-7.   End-stage renal disease due to diabetes
- 4-8a.  Medical evaluation for persons with type 1 or type 2 	   	  diabetes and chronic kidney disease
- 4-8b.  Medical treatment for persons with type 1 or type 2 	  	  diabetes and chronic kidney disease

**Status of Chronic Kidney Disease Objectives**

**Improving**

**Getting worse**

**Baseline data only**

**Target met**

**Notes:**
No objective that can be assessed is moving in the wrong direction.

## End-stage Renal Disease, 

**End-stage Renal Disease, **
**By Race/Hispanic Origin**

**Obj. 4-1**

- Note: American Indian includes Alaska Native.  Asian includes Pacific Islander. Persons of Hispanic origin may be any race.
- SOURCE: United States Renal Data System (USRDS), NIH, NIDDK.

## End-stage Renal Disease Due to Diabetes, 

**End-stage Renal Disease Due to Diabetes, **
**By Race/Hispanic Origin**

**Obj. 4-7**

- Note: American Indian includes Alaska Native.  Asian includes Pacific Islander. Persons of Hispanic origin may be any race.
- SOURCE: United States Renal Data System (USRDS), NIH, NIDDK.

## ESRD and ESRD Due to Diabetes,

**Asian**

**1999**

**2000**

**2001**

**2002**

**2003**

**Total**

**White**

**Black**

**Hispanic**

**American Indian**

**1998**

**1997**

**2004**

**1,200**

**1,000**

**   ****800**

**   ****600**

**   ****400**

**   ****0**

**ESRD and ESRD Due to Diabetes,**
**By Race/Hispanic Origin**

**Incidence rate per million**

**   **

**1999**

**2000**

**2001**

**2002**

**2003**

**1998**

**1997**

**2004**

**1,200**

**1,000**

**   ****800**

**   ****600**

**   ****400**

**   ****200**

**   ****0**

**Asian**

**2010 Target**

**Total**

**Black**

**Hispanic**

**American Indian**

**   ****200**

**White**

**Obj. 4-1**

- Note: American Indian includes Alaska Native.  Asian includes Pacific Islander. Persons of Hispanic origin may be any race.
- SOURCE: United States Renal Data System (USRDS), NIH, NIDDK.

**Obj. 4-7**

**End-stage Renal Disease**

**End-stage Renal Disease**
**Due to Diabetes**

**2010 Target**

## End-stage Renal Disease, 

**End-stage Renal Disease, **
**By Race and Gender**

**Incidence rate per 1,000,000**

**Obj. 4-1**

- Note: American Indian includes Alaska Native.  Asian includes Pacific Islander.
- SOURCE: United States Renal Data System (USRDS), NIH, NIDDK.

- _Men_

- _Women_

**Asian**

**American Indian**

**Black**

**White**

**Asian**

**American Indian**

**Black**

**White**

**1,200**

**1,000**

**800**

**600**

**400**

**200**

**0**

**1998-2000 **

**2001-2003**

**2010 Target**

## End-stage Renal Disease, 

**End-stage Renal Disease, **
**By Health Service Area, 1993**

**Incidence rate per 1,000,000 population**

**Obj. 4-1**

- SOURCE: United States Renal Data System (USRDS), NIH, NIDDK.

## End-stage Renal Disease, 

**End-stage Renal Disease, **
**By Health Service Area, 2003**

**Incidence rate per 1,000,000 population**

**Obj. 4-1**

- SOURCE: United States Renal Data System (USRDS), NIH, NIDDK.

## End-stage Renal Disease Due to Diabetes, 

**Males**

**End-stage Renal Disease Due to Diabetes, **
**By Gender**

**Incidence rate per 1,000,000 population**

**2010 Target**

**Total**

**Females**

**Obj. 4-7**

- SOURCE:United States Renal Data System (USRDS), NIH, NIDDK.

**1999**

**2000**

**2001**

**2002**

**2003**

**1998**

**1997**

**2004**

**200**

**180**

**160**

**140**

**120**

**100**

**80**

**60**

**40**

**20**

**0**

## Use of Arteriovenous Fistulas* 

**Asian**

**Use of Arteriovenous Fistulas* **
**Among the Newly Diagnosed **
**By Race/Hispanic Origin**

**Percent**

**1999**

**2000**

**2001**

**2002**

**2003**

**2010 Target**

**Total**

**White**

**Black**

**Hispanic**

**American Indian**

**Obj. 4-4**

- Note: American Indian includes Alaska Native.  Asian includes Pacific Islander. The categories black  and white exclude persons of Hispanic origin.   Persons of Hispanic origin may be any race. SOURCE: Centers for Medicare and Medicaid Services (CMS) Clinical Performace Measures (CPM) project.

**1998**

**50**

**60**

**40**

**30**

**20**

**10**

**0**

**70**

**80**

## Use of Arteriovenous Fistulas 

**Females**

**Use of Arteriovenous Fistulas **
**Among the Newly Diagnosed**
**By Gender**

**Percent**

**1999**

**2000**

**2001**

**2002**

**2003**

**2010 Target**

**Total**

**Males**

**Obj. 4-4**

- SOURCE: Centers for Medicare and Medicaid Services (CMS) Clinical Performance Measures (CPM) project.

**1998**

**50**

**60**

**40**

**30**

**20**

**10**

**0**

## Medical Evaluation for Persons with Diabetes and Chronic Kidney Disease

**Percent**

**2010 Target**

**Obj. 4-8a**

**2000**

**2001**

**2002**

**2003**

**2004**

- Note:  American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander.  Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option.
- SOURCE:  Centers for Medicare and Medicaid Services (CMS); United States Renal Data System (USRDS), NIH, NIDDK.

**Asian**

**White**

**Black**

**Hispanic**

**American Indian**

**50**

**60**

**40**

**30**

**20**

**10**

**0**

**Medical Evaluation for Persons with Diabetes and Chronic Kidney Disease**

## Medical Evaluation for Persons with Diabetes and Chronic Kidney Disease

**Percent**

**2010 Target**

**Obj. 4-8a**

**2000**

**2001**

**2002**

**2003**

**2004**

- Note:  American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander.  Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option.
- SOURCE:  Centers for Medicare and Medicaid Services (CMS); United States Renal Data System (USRDS), NIH, NIDDK.

**Asian**

**White**

**Black**

**Hispanic**

**American Indian**

**50**

**60**

**40**

**30**

**20**

**10**

**0**

**Medical Evaluation for Persons with Diabetes and Chronic Kidney Disease**

- Medical evaluation include eye examinations, lipid testing, and glycosylated hemoglobin (HbA1c) testing

## Medical Treatment for Persons with Diabetes and Chronic Kidney Disease

**0**

**Percent**

**2010**
**Target**

**40**

**20**

**Total **

**Hispanic**

**Asian**

**Obj. 4-8b**

**American Indian**

**Black**

**White**

**Native Hawaiian**

**Medical Treatment for Persons with Diabetes and Chronic Kidney Disease**

- Note:  American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander.  Persons of Hispanic origin may be any race.
- SOURCE:  USRDS.

*****

**30**

**10**

*****

*****

*****

**2000**

**Notes:**
High rate of visual impairment due to glaucoma in BNH reflects high rate of diabetes in this subpopulation.

## Medical Treatment for Persons with Diabetes and Chronic Kidney Disease

**0**

**Percent**

**2010**
**Target**

**40**

**20**

**Total **

**Hispanic**

**Asian**

**Obj. 4-8b**

**American Indian**

**Black**

**White**

**Native Hawaiian**

**Medical Treatment for Persons with Diabetes and Chronic Kidney Disease**

- Note:  American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander.  Persons of Hispanic origin may be any race.
- SOURCE:  USRDS.

*****

**30**

**10**

*****

*****

*****

- Medical treatment includes the use of angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARB)

**2000**

**Notes:**
High rate of visual impairment due to glaucoma in BNH reflects high rate of diabetes in this subpopulation.

## http://www.cdc.gov/nchs/hphome.htm

**Progress review data and slides**
**are available on the web at:**

**http://www.cdc.gov/nchs/hphome.htm**