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CKD-11.3 Data Details

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CKD-11.3 Increase the proportion of adult hemodialysis patients who use arteriovenous fistulas or have a maturing fistula as the primary mode of vascular access at the start of renal replacement therapy

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
Clinical Performance Measures Project
United States Renal Data System
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
31.6 (2007)
Target: 
34.8
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of new hemodialysis patients with a Medical Evidence Form (CMS-2728) aged 18 years and over indicating use of an AV fistula or maturing fistula as the primary mode of vascular access

Denominator: 

Number of new hemodialysis patients with a completed Medical Evidence Form (CMS-2728), aged 18 years and over

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From CMS Medical Evidence Form 2728:

    [NUMERATOR:]

    What access was used on first outpatient dialysis?

    1. AV Fistula
    2. Graft
    3. Catheter
    4. Other
    5. Unknown

    If not AVF, then is maturing AVF present?

    1. Yes
    2. No
Data Collection Frequency: 
Annual
Methodology Notes: 

    The United States Renal Data System (USRDS) uses data collected by the Centers for Medicare and Medicaid Services. Since 1996, Health Care providers have been required to provide patient information on all persons with end-stage renal disease (ESRD), regardless of health insurance. Therefore, incident rates reflect the universe of ESRD cases in the United States. The cohorts include new hemodialysis patients, limited to those age 18 and older at initiation and with a known vascular access at that time.

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 4-4, which tracked the use of arteriovenous fistulas as the primary mode of vascular access by new hemodialysis patients aged 20 years and over. This objective tracks the use of arteriovenous fistulas or maturing fistulas as the primary mode of vascular access by new hemodialysis patients aged 18 years and over.

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
Clinical Performance Measures Project
United States Renal Data System
Measure: 
percent
Numerator: 

Number of new hemodialysis patients with a Medical Evidence Form (CMS-2728) aged 18 years and over indicating use of an AV fistula or maturing fistula as the primary mode of vascular access

Denominator: 

Number of new hemodialysis patients with a completed Medical Evidence Form (CMS-2728), aged 18 years and over

Questions Used to Obtain the State Data: 

      From CMS Medical Evidence Form 2728:

      [NUMERATOR:]

      What access was used on first outpatient dialysis?

      1. AV Fistula
      2. Graft
      3. Catheter
      4. Other
      5. Unknown

      If not AVF, then is maturing AVF present?

      1. Yes
      2. No
Data Collection Frequency: 
Annual
Methodology Notes: 

      The United States Renal Data System (USRDS) uses data collected by the Centers for Medicare and Medicaid Services. Since 1996, Health Care providers have been required to provide patient information on all persons with end-stage renal disease (ESRD), regardless of health insurance. Therefore, incident rates reflect the universe of ESRD cases in the United States. The cohorts include new hemodialysis patients, limited to those age 18 and older at initiation and with a known vascular access at that time.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2018, the original baseline was revised from 31.3 to 31.6 percent due to USRDS rates re-estimation. There is some lag in reporting new cases of ESRD. Therefore, each year’s Annual Data Report includes re-estimates of earlier year rates. For more information see the USRDS Annual Data Reports. The target was adjusted from 34.4 to 34.8 percent to reflect the revised baseline using the original target-setting method.

References

Additional resources about the objective

  1. More information on the analytic methods used to calculate these rates can be found in Appendix A of the USRDS Annual Data Report Atlas

  2. U.S. Renal Data System, USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2012