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News From the Centers for Disease Control and Prevention
May 14, 2008

Hospitalization Discharge Diagnoses for Kidney Disease—United States, 1980-2005

JAMA. 2008;299(18):2144-2145. doi:10.1001/jama.299.18.2144

MMWR. 2008;57:309-312

2 figures, 1 table omitted

Kidney disease is the ninth leading cause of death in the United States.1 Nearly 26 million persons in the United States have chronic kidney disease (CKD), and another 20 million are at increased risk for CKD.2 End-stage renal disease (ESRD), which can be caused by either CKD or acute renal failure (ARF), results in approximately 85,000 deaths each year in the United States.3 The total annual cost of treating ESRD in the United States was approximately $33 billion in 2005.3 Much of the care for CKD and ESRD is provided in the outpatient setting; however, the number of hospitalizations for ARF and chronic kidney failure (CKF) is substantial. In 2004, an estimated 221,000 hospitalizations with a first-listed discharge diagnosis of ARF and 19,000 with a first-listed discharge diagnosis of CKF occurred in the United States.4 To characterize national trends in kidney disease hospitalizations, CDC analyzed data from the National Hospital Discharge Survey (NHDS) for the period 1980-2005. This report summarizes the results of that analysis, which indicated that (1) numbers and rates of kidney disease hospital discharge diagnoses have increased since the early 1990s, especially among adults aged ≥65 years; (2) a shift has occurred in the type of kidney disease accounting for most of these reported hospitalizations (from CKF to ARF); and (3) an increasing number of kidney disease hospital discharges are associated with a concomitant diagnosis of diabetes mellitus or hypertension. These findings indicate a need for additional research to determine the cause of the increase in ARF discharge diagnoses and to quantify the progression from ARF to CKD and ESRD.