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CKD-14.3 Data Details

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CKD-14.3 Reduce the number of cardiovascular deaths for persons on dialysis

About the Data

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

Data Source: 
United States Renal Data System
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
per 1,000 patients years at risk
Baseline (Year): 
90.3 (2007)
Target: 
81.3
Target-Setting Method: 
10 percent improvement
Numerator: 

Cardiovascular deaths among persons on dialysis.

Denominator: 

Period prevalent dialysis population.

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Data Collection Frequency: 
Annual
Methodology Notes: 

    This measure is translated into patient years at risk (instead of a rate per population) in order to obtain a more uniform rate to track over time. Cohorts for these tables include period prevalent dialysis patients in each calendar year, 2000–2010, whose first end-stage renal disease (ESRD) service date is at least 90 days prior to the beginning of the year (point prevalent patients on January 1) or who reach day 91 of ESRD treatment during the year (incident patients).

    Patients with unknown age, gender, or race, and those with an age calculated to be less than zero are excluded, as are patients who are not residents of the 50 states, the District of Columbia, Puerto Rico, or the Territories.

    Age is calculated on January 1. Race is defined from the ESRD Medical Evidence form. Cardiovascular mortality is defined using codes from past and current ESRD Death Notification Form CMS-2746-U3: 01, 02, 03, 04, 23, 25, 26, 27, 28, 29, 30, 31, 32, 36, and 37.

    Patients are followed from January 1 (for point prevalent dialysis patients) or day 91 of ESRD (for incident dialysis patients) until death, transplant, or December 31 of the year. Rates are estimated as the number of patients who die from cardiovascular disease in each year, per 1,000 patient years at risk.

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 14.3, in that the denominator for the Healthy People 2010 objective was the number of persons with ESRD, while the denominator for this objective is the period prevalent dialysis population.

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 90.4 to 90.3 deaths per 1,000 patients years at risk 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 81.4 to 81.3 deaths per 1,000 patients years at risk 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