Kidney Disease Statistics 

for the United States 

National Kidney and Urologic Diseases Information Clearinghouse 

The Growing Burden of Kidney Disease 

Kidney disease statistics for the United 

States convey the burden of chronic 

kidney disease (CKD) and end-stage renal 

disease (ESRD). Based on these statistics, researchers can estimate the size of 

the ESRD population in years to come 

and gauge the need for resources such as 

dialysis and transplant clinics to treat the 

growing ESRD population. 

Over time, kidney disease statistics show 

trends and movement. For example, statistics show which ethnic and age groups 

and geographical regions have the highest 

incidence of kidney disease. This demographic information helps direct targeted 

programs to the people who need them 

most. Statistics can later help measure 

progress in preventing and treating kidney 

disease. With the knowledge provided 

by statistics, researchers and health care 

providers can make great gains in the fi ght 

against kidney disease. 

Unless otherwise noted, the following 

statistics are from the United States Renal 

Data System’s 2010 Annual Data Report and 

2011 Annual Data Report. 

Defi nitions 

chronic kidney disease (CKD): 

any condition that causes reduced 

kidney function over a period of 

time. CKD is present when a patient’s 

glomerular filtration rate remains below 

60 milliliters per minute for more than 

3 months or when a patient’s urine 

albumin-to-creatinine ratio is over 

30 milligrams (mg) of albumin for each 

gram (g) of creatinine (30 mg/g). 

end-stage renal disease (ESRD): total 

and permanent kidney failure. When 

the kidneys fail, the body retains fl uid. 

Harmful wastes build up. A person with 

ESRD needs treatment to replace the 

work of the failed kidneys. 

acute kidney injury (AKI): sudden, 

temporary, and sometimes fatal loss of 

kidney function 

incidence: the number of new cases 

of a disease in a given time period 

prevalence: the number of existing 

cases of a disease at a given point 

in time 

CKD General Prevalence 

One in 10 

American adults, 

more than 

20 million, have 

some level of CKD. 

Source: Centers for Disease 

Control and Prevention 
 

CKD Incidence 

■ The incidence of CKD is increasing most rapidly in people ages 65 and older. 

■ The incidence of recognized CKD in people ages 65 and older more than doubled between 2000 

and 2008. 

■ The incidence of recognized CKD among 20- to 64-year-olds is less than 0.5 percent. 

4.5 

4.0 

3.5 

3.0 

2.5 

2.0 

1.5 

1.0 

0.5 

0 

B

B

B

B

B

B

B B

B

J J J J J J J

2000 2001 2002 2003 2004 2005 2006 2007 2008 

B

J MarketScan ages 20–64

Medicare ages 65+ 

J J

Year

*MarketScan represents data from employer group health plans. 

Percent of Population with 

New Cases of CKD, by Age Group 

Percent

CKD Prevalence 

■ The prevalence of CKD is growing most rapidly 

in people ages 60 and older. 

■ Between the 1988–1994 National Health and 

Nutrition Examination Survey (NHANES) 

study and the 2003–2006 NHANES study, the 


prevalence of CKD in people ages 60 and older 


jumped from 18.8 to 24.5 percent.
 

■ During that same period, the prevalence of 

CKD in people between the ages of 20 and 

39 stayed consistently below 0.5 percent. 

30 

25 

20 

Percent of Population with 


Stage 3 CKD, by Age Group
 

Ages 20–39
 

Ages 60+ 26.0%
 

24.2% 24.5% 

18.8% 

Percent

10 

5 

0.1% 0.3% 0.1% 0.2% 0 

NHANES NHANES NHANES NHANES

1988–1994 1999–2002 2003–2006 2001–2008

Years

15 

2 | Kidney Disease Statistics for the United States 
ESRD Incident Rate 

After rising steadily from 1980 to 2001, the incident rate of ESRD leveled off. 

0

50

100

150

200

250

300

350

400

Rate per Million 

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

Year 

2009

Adjusted Incident Rates of ESRD 

ESRD Incident Rates by Race 

■ ESRD incident rates are more than three times higher for African Americans than for Caucasians. 

Kidney Disease Statistics for the United States | 3 

■ After rising from 1980 to 2000, the incident rates for all races stabilized. 

■ African American rates rose more quickly than rates for all other races. 

■ In 2001, incident rates for American Indians started to decline. 

0

200

400

600

800

1,000

1,200

F

B

J

H

F

J J J

J J J J

J

J

J

J

J J

J

J J J J

J J J J J

F

H H H H H H H

H H H

H H H H H H

H H H H

H H H H H H

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008 

H H H

J J J J J J

F F

F

F

F F F F F

F F

F F F

F F

F F

F

F F F F F

F F

F

Caucasian 

Asian 

African American 

American Indian 

All 

Rate per Million 

Year 

J

F

H

2009 

Adjusted Incident Rates of ESRD by Race 
4 | Kidney Disease Statistics for the United States 

ESRD Prevalence and Prevalent Rate 

■ At the end of 2009, more than 871,000 people were being treated for ESRD. 

■ Between 1980 and 2009, the prevalent rate for ESRD increased nearly 600 percent, from 290 to 1,738 

cases per million. 

 

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Adjusted Prevalent Rates of ESRD 

2,000

1,500

1,000

500

Rate per Million 

0

Year 
AKI Incidence 

■	 The number of hospitalizations that included an AKI diagnosis rose from 3,942 in 1996 to 23,052 in 

2008. 

■ The percentage of AKI diagnoses that required dialysis declined from 13.39 in 1996 to 2.25 in 2008. Number of Hospitalizations

Any AKI Diagnosis 

25,000 

20,000 

15,000 

10,000 

5,000 

0 

B

B

B

B

B

1996 1999 2002 2005 2008 

Year 

AKI Diagnosis with Dialysis 

Percent 

14 

12 

10 

8 

6 

4 

2 

0 

J

J

J

J

J

1996 1999 2002 2005 2008 

Year 

Kidney Disease Statistics for the United States | 5 
 

CKD Co-morbidities 

■	 People with no CKD are more likely than people with stage 3 to 5 CKD to be alive 1 year after a heart 

attack. 

■	 The 1-year mortality for heart attack patients without identified CKD is 36 percent, compared with 

51 percent for patients with stage 3 to 5 CKD. 

ESRD Treatment Modality 

■	 At the end of 2009, 398,861 ESRD patients 

were being treated with some form of dialysis; 

172,553 ESRD patients had a working transplanted kidney.
 

■	 More than 10 times as many ESRD patients 

receive hemodialysis (HD) treatments at a 

clinic as those who do peritoneal dialysis (PD) 

and home HD combined. 

 Percent 

All-cause Survival in Patients with a First Diagnosis 

of Cardiovascular Disease, by CKD Stage, 2007–2008 

1.0 

0.9 

0.8 

0.7 

0.6 

0.5 

0.4 

0.3 

0.2 

0.1 

0 

BJ

B

B J

J

B B B B B B B J J

B B B

J J J J J J J J

B No CKD 

J CKD Stage 3–5 

0 1 2 3 4 5 6 7 8 9 10 11 12 

Months Number of ESRD Patietns 

Number of ESRD Patients 

300,000 Dialysis Patients 

Other or uncertain 

dialysis (1,262)

by Treatment Modality 

250,000 

400,000

350,000 

Continuous cycler-assisted 

peritoneal dialysis (18,064) 

200,000 Continuous ambulatory 

peritoneal dialysis (9,458) 

Home HD (4,511)

150,000 In-center HD (365,566) 

100,000 

50,000 

0 

Transplant Dialysis
 

Patients Patients
 

(172,553) (398,861)
 

6 	 | Kidney Disease Statistics for the United States 
Kidney Transplantation 

After rising steadily from 1980 to 2006, the annual number of kidney transplants declined in 2007 

and 2008. 

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008 

Number 

2009 

Annual Number of Kidney Transplants 

20,000 

15,000 

10,000 

5,000 

J B H

J

J J

J J

J J

J J J J

J J

H H H

H

H H

H H

H H H

H H H H

H H

H

J

J J

Total Deceased Donor Living Donor

H H H

J

J J J

J

J

H

0 

Year 

Kidney Disease Statistics for the United States | 7 
 

ESRD Mortality 

■	 Though the total number of ESRD patient deaths has continued to rise, the death rate has declined 

in recent years after peaking in 2001. 

■ The number of deaths from ESRD rose from 10,478 in 1980 to 90,118 in 2009. 

Unadjusted Annual Mortality for ESRD Patients 

1980 1985 1990 1995 2000 2005 2009 

Mortality Rates for ESRD Patients 

Year 

200 

150 

100 

50 

0 

Number of Deaths per 1,000 Patients, Years at Risk

Total Patient Deaths for ESRD Patients 

100,000 

90,000 

80,000 

70,000 

60,000 

50,000 

40,000 

30,000 

20,000 

10,000 

0 

Number of Patient Deaths 

B

B

B

B

B

B

B

1980 1985 1990 1995 2000 2005 2009 

Year 

8 	 | Kidney Disease Statistics for the United States 
Mortality Rates for Dialysis Patients 

After rising from 1980 to 2001, mortality rates for dialysis patients started to fall every year. By 

2008, they had returned to early 1980s levels. 

1980

1985

1990

1995

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Death Rates for Patients on Dialysis 

Number of Deaths per 1,000 Patients, Years at Risk 

0

50

100

150

200

250

Year 

General Graft Survival Rates 

The percentage of grafts transplanted in 1980 

that survived to 1990 was 25.7. That percentage improved steadily in the following 

decades, with the survival rate from 1999 to 

2009 rising to 44.9. 

1980–1990

1985–19951990–20001995–2005

1996–2006

1997–20071998–2008

1999–2009

Percent

10-year General Graft Survival Rates

50

40

30

0

20

10

Years

Kidney Disease Statistics for the United States | 9 
 

Graft Survival Rates by Race 

While graft survival is lower in African Americans than in Caucasians, patient survival rates are 

about equal. Percent 

100 

3 months

(2008–2009) 

1 year

(2008–2009) 

5 years

(2004–2009) 

10 years

(1999–2009) 

B Caucasians 

J African Americans 

B

B

B

B

J

J

J

J

Graft Survival Rates by Race 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Patient Survival Rates for Dialysis and Transplant Patients 

At 85.5 percent, the 5-year survival rate for transplant patients is more than twice the 35.8 percent 

survival rate for dialysis patients. Percent 

100 

B Dialysis Patients 

J Transplant Patients 

B

B

B

B

J J J

J

Patient Survival Rates by Dialysis and Transplant 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

1 year 2 years 3 years 4 years 5 years 

(2008–2009) (2007–2009) (2006–2009) (2005–2009) (2004–2009) 

No data 

available 

10 | Kidney Disease Statistics for the United States 
ESRD Costs 

Treating ESRD patients cost the United States over $40 billion in public and private funds in 2009. 

 

$10.68

ESRD Costs in Billions 

Non-Medicare Costs Medicare Costs 

Total: $42.50 

2009 

Total: $31.99 

2005 

$4.70

$12.04 $13.82

$5.53 $29.03

 

Costs per Patient 

■ ESRD annual expenditures per patient have increased slightly in recent years. 

■ From 2006 to 2007, transplant costs per patient decreased but increased again in 2008. 

■ Yearly costs for treating a patient on HD are nearly triple the costs for treating a transplant patient. 

 

 

Kidney Disease Statistics for the United States | 11 

Total: $19.35 

2000 

Total: $16.74 

1998 

$13.47

$21.31

0 

$20,000 

$40,000 

$60,000 

$80,000 

$100,000 

HD PD Tx All ESRD 

2006 2007 2008 

Year 

Cost 

$90,000 

$10,000 

$30,000 

$50,000 

$70,000 

2009 

Annual ESRD Treatment Costs per Patient 

for HD, PD, Transplantation (Tx), and all ESRD 
 

Defi nition 

vascular access: a general term to describe where blood is removed from and returned to 

the body during HD. A vascular access may be an arteriovenous (AV) fistula, an AV graft, or 

a catheter. An AV fistula is the preferred type of vascular access because it causes fewer 

problems with infection and clotting. Catheters have the most problems with infection. 

AV Fistula Use among Men and Women 

■ AV fi stula use increased from 27.9 to 55.0 percent between 1998 and 2007. 

■ AV fi stula use increased in both men and women. 

■ AV fistula use rates among men were twice as high as among women in the late 1990s. 

■ Women have begun to narrow the gap in AV fi stula use. 

Percentage of Patients with an AV Fistula 

70 

60 

50 

40 

30 

20 

10 

0 

B B

B

B B B

B

B

B

B

J J J J

J

J

J J

J

J

H H

H

H

H H

H

H

H

H

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 

B Male H All J Female

Year 

12 | Kidney Disease Statistics for the United States Percent
AV Graft Use among Men and Women 

■ The decline in AV graft use mirrors the rise in AV fi stula use. 

■ AV graft use among women is higher than among men. 

■ The gap in AV graft use among men and women narrowed gradually between 1998 and 2007. Percent 

Percent of Patients with an AV Graft 

70
 

60
 

50
 

40
 

30
 

20
 

10
 

0
 

B B

B

B B B

B

B

B

B

J

J

J J

J

J

J J

J

J

H

H

H

H

H

H

H

H

H

H

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 

B Male H All J Female

Year 

Kidney Disease Statistics for the United States | 13
 
 

Around 18 percent of dialysis patients use a catheter for their vascular access. 

Catheter Use for Vascular Access Percent 

Percent of All Patients with a Catheter 

20
 

15
 

10
 

5
 

0 

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
 

Year 

14 | Kidney Disease Statistics for the United States 
 

Acknowledgments 

Publications produced by the Clearinghouse 

are carefully reviewed by both NIDDK 

scientists and outside experts. 

National Kidney Disease 

Education Program 

3 Kidney Information Way 

Bethesda, MD 20892 

Phone: 1–866–4–KIDNEY (1–866–454–3639) 

TTY: 1–866–569–1162 

Fax: 301–402–8182 

Email: nkdep@info.niddk.nih.gov 

Internet: www.nkdep.nih.gov 

The National Kidney Disease Education Program (NKDEP) is an initiative of the National 

Institute of Diabetes and Digestive and Kidney 

Diseases, National Institutes of Health, U.S. 

Department of Health and Human Services. 

The NKDEP aims to raise awareness of the 

seriousness of kidney disease, the importance 

of testing those at high risk, and the availability 

of treatment to prevent or slow kidney disease. 

Kidney Disease Statistics for the United States | 15 
National Kidney and Urologic 

Diseases Information Clearinghouse 

3 Information Way 

Bethesda, MD 20892–3580 

Phone: 1–800–891–5390 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: nkudic@info.niddk.nih.gov 

Internet: www.kidney.niddk.nih.gov 

The National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC) is a 

service of the National Institute of Diabetes 

and Digestive and Kidney Diseases (NIDDK). 

The NIDDK is part of the National Institutes 

of Health of the U.S. Department of Health 

 

and Human Services. Established in 1987, the 

Clearinghouse provides information about 

diseases of the kidneys and urologic system to 

people with kidney and urologic disorders and 

to their families, health care professionals, and 

the public. The NKUDIC answers inquiries, 

develops and distributes publications, and 

works closely with professional and patient 

organizations and Government agencies to 

coordinate resources about kidney and urologic 

diseases. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this publication to duplicate and 

distribute as many copies as desired. 

This publication is available at www.kidney.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 12–3895 

June 2012 

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