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CKD-5 Data Details

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CKD-5 Increase the proportion of persons with diabetes and chronic kidney disease who receive recommended medical treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBS)

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: 
percent
Baseline (Year): 
67.4 (2007)
Target: 
76.3
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of persons aged 65 years and over with diabetes and chronic kidney disease who have at least one prescription for ACE and/or ARB

Denominator: 

Number of persons aged 65 years and over with diabetes and chronic kidney disease

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Methodology Notes: 

    Medication use is obtained from Part D prescription data in the Medicare 5% sample. The cohort includes general Medicare patients diagnosed with both diabetes and chronic kidney disease in each year, who are aged 65 years and over at the beginning of the year and continuously enrolled in the Medicare inpatient/outpatient and physician/supplier program during the entire year. In 2007–2010, patients are enrolled in Medicare Part D during the entire year. Use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBS) is defined by at least one prescription fill from either drug class during the year.

    The United States Renal Data System (USRDS) data, data collection procedures, calculation methods, and other technical information are included in the USRDS Annual Data Report.

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 4-8b which measured recommended medical management including the use of drugs that modify the renin-angiotensin-aldosterone system (RAAS), such as angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). The recommendations for medical treatment of persons with type 1 or type 2 diabetes and CKD have been updated and currently include angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBS). Consequently, data for this objective are not comparable with data for the Healthy People 2010 objective.

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 54.6 to 69.4 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 60.0 to 76.3 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