2009 ADR v2 Atlas of ESRD - United States Renal Data System

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__________________________________________________________________________ Recipient typed name, title, & organization ___________________________________________________________________________ Recipient telephone number ___________________________________________________________________________ Recipient signature & date ___________________________________________________________________________ Contractor typed name, title, & organization, as appropriate ___________________________________________________________________________ Contractor telephone number ___________________________________________________________________________ Contractor signature & date Lawrence Y. C. Agodoa, MD, NIDDK, NIH or Paul W. Eggers, PhD, NIDDK, NIH USRDS Project Offi cer ___________________________________________________________________________ USRDS Project Offi cer signature & date May 2004
United States Renal Data System (USRDS) International Data Collection Form Th is form is designed to solicit information on the population of End-Stage Renal Disease (ESRD) patients in your country. Th e information you provide will be returned to you along with comparable information from other countries participating in the voluntary eff ort. Th e form has been changed and expanded to provide more detail in age-specifi c categories. If you cannot provide data in the age categories listed, please provide the total numbers. Th e format has also been changed to more clearly separate incident and prevalent population counts from transplant counts. A) Population: the population of your country for the most recent year available B) Incidence: the count of patients who start any form of renal replacement therapy during the year. Th ese are fi rst-time patients only; patients who start dialysis aft er a failed transplant, for example, should not be included. B2) Th e subset of total incident patients whose failure is due to diabetic nephropathy. Subtracting B2 from B1 should give the total number of incident patients for all non-diabetic nephropathy causes. C) Prevalence: the point prevalent count of patients at the end of the calendar year (December 31). C1) All patients on some form of treatment, dialysis or transplantation. C2) Patients with a functioning kidney transplant as of December 31. C3) All dialysis patients. C2 and C3 should sum to C1 unless there are lost-to-follow-up patients. If there are lost-tofollow-up patients, please note this fact and whether these patients are captured in C2. C4) All patients treated with in-center hemodialysis as of December 31. C5) All patients treated with CAPD or CCPD as of December 31. C6) All patients treated with home hemodialysis as of December 31. C4, C5, and C6 are subsets of all dialysis patients (C3). Th ey should not total to more than C3. Th ey may, however, sum to less than C3 due to unknown or other types of dialysis. D) Transplant activity: Th is is meant to be a count of transplants, not transplanted patients. If a patient receives multiple transplants during the year, all should be counted. If you report only transplanted patients, please provide these numbers and note that they refer to patients. D1 (cadaveric transplants) and D2 (living donor transplants) should sum to the total number of transplants. If there are a number of transplants with unknown donor types, or if you cannot separate transplants by donor type, please report the total number of transplants. You may return this form to us by email or fax: usrds@usrds.org, and 1.612.347.5878. Country _____________________________ A) Population of country 0–19 20–44 45–64 65–74 75+ Total 2005 __________ __________ __________ __________ __________ __________ 2006 __________ __________ __________ __________ __________ __________ 2007 __________ __________ __________ __________ __________ __________ 2008 __________ __________ __________ __________ __________ __________ B1) Incidence: Total number of incident (new) patients starting renal replacement therapy during the year 0–19 20–44 45–64 65–74 75+ Total 2005 __________ __________ __________ __________ __________ __________ 2006 __________ __________ __________ __________ __________ __________ 2007 __________ __________ __________ __________ __________ __________ 2008 __________ __________ __________ __________ __________ __________ B2) Incidence: Total number of incident patients starting renal replacement therapy during the year due to diabetes 0–19 20–44 45–64 65–74 75+ Total 2005 __________ __________ __________ __________ __________ __________ 2006 __________ __________ __________ __________ __________ __________ 2007 __________ __________ __________ __________ __________ __________ 2008 __________ __________ __________ __________ __________ __________
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Page 5 and 6: the sample for four years, with app
Page 7 and 8: Patient treatment histories compile
Page 9 and 10: each patient, we calculate a mean U
Page 11 and 12: ence Section G; here, however, inci
Page 13 and 14: dialysis patients in 2007, each pat
Page 15 and 16: therapy on January 1, with a first
Page 17 and 18: while a prevalent patient dying dur
Page 19 and 20: 6. Alaska, Hawaii, Idaho, Montana,
Page 21 and 22: the given year, regardless of when
Page 23 and 24: period for evaluating care after ho
Page 25 and 26: survive, continue dialysis, and car
Page 27 and 28: a dii Medicare categories of paymen
Page 29 and 30: 4 the Philippines Renal Disease Reg
Page 31 and 32: each table. The marginal rates are
Page 33 and 34: Levey AS, Berg RL, Gassman JJ, Hall
Page 35 and 36: Dialyzers Th e Case Mix Severity, C
Page 37 and 38: quality of life and nutrition issue
Page 39 and 40: Medicare enrollment for the periods
Page 41 and 42: ESRD Facility Survey Data for this
Page 43: United States Renal Data System (US
Page 47 and 48: DEPARTMENT OF HEALTH AND HUMAN SERV
Page 49 and 50: LIST OF PRIMARY CAUSES OF END STAGE
Page 51 and 52: C. COMPLETE FOR ALL KIDNEY TRANSPLA
Page 53 and 54: Medical Evidence form (2728), 1987
Page 55 and 56: CARDIAC 23 Myocardial infarction, a
Page 57 and 58: ESRD DEATH NOTIFICATION FORM LIST O
Page 59 and 60: DEPARTMENT OF HEALTH AND HUMAN SERV
Page 61 and 62: access, dialysis. See vascular acce
Page 63 and 64: during transition to ESRD 135, 341
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2009 ADR v2 Atlas of ESRD - United States Renal Data System

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