1. 2015 ANNUAL DATA REPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE Chapter 9: Cardiovascular Disease in Patients With ESRD

2. Data Source: Reference Table H12. Abbreviations: AHD, atherosclerotic heart disease; AMI, acute myocardial infarction; CHF, congestive heart failure; CVA, cerebrovascular accident. Figure 9.1 Causes of death in ESRD patients, 2013 Vol 2, ESRD, Ch 92

3. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients at all ages, with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2012. Abbreviations: AFIB, atrial fibrillation; AMI, acute myocardial infarction; ASHD, atherosclerotic heart disease; CHF, congestive heart failure; CKD, chronic kidney disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; CVD, cardiovascular disease; PAD, peripheral arterial disease; SCA/VA, sudden cardiac arrest and ventricular arrhythmias. Figure 9.2 Prevalence of cardiovascular diseases in ESRD patients, by treatment modality, 2013 Vol 2, ESRD, Ch 93

4. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients at all ages, with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2012.Abbreviations: AFIB, atrial fibrillation; AMI, acute myocardial infarction; ASHD, atherosclerotic heart disease; CHF, congestive heart failure; CKD, chronic kidney disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; CVD, cardiovascular disease; PAD, peripheral arterial disease; SCA/VA, sudden cardiac arrest and ventricular arrhythmias. Figure 9.3 Prevalence of cardiovascular diseases in ESRD patients, by age, 2013 Vol 2, ESRD, Ch 94

5. Table 9.1 Prevalence of cardiovascular diseases & procedures in ESRD patients, by treatment modality, age, race, & sex, 2013 Vol 2, ESRD, Ch 95 # Patients % Patients Overall0-2122-4445-6465-7475+White Blk/Af Am OtherMaleFemale Cardiovascular Comorbidities a Atherosclerotic heart disease (ASHD) Hemodialysis 147,37340.82.515.636.849.752.145.136.038.440.940.7 Peritoneal dialysis 11,18032.00.911.931.744.049.135.425.727.536.527.5 Transplant 23,46522.30.46.119.336.843.224.019.018.324.019.7 Acute myocardial infarction (AMI) Hemodialysis 147,37313.70.05.412.516.517.415.112.1 13.713.6 Peritoneal dialysis 11,18011.20.54.111.115.617.212.69.08.112.89.6 Transplant 23,4657.30.02.36.811.213.57.96.1 7.86.5 Congestive heart failure (CHF) Hemodialysis 147,37337.210.722.433.742.245.937.837.132.035.439.4 Peritoneal dialysis 11,18025.26.516.023.832.035.525.525.621.327.223.3 Transplant 23,46518.72.26.915.529.139.519.118.813.818.918.4 Cerebrovascular accident/transient ischemic attack (CVA/TIA) Hemodialysis 147,37315.02.85.512.519.020.315.015.413.013.516.9 Peritoneal dialysis 11,18011.31.45.59.916.617.412.010.77.611.011.6 Transplant 23,4657.80.62.46.213.017.58.27.55.27.68.1 Peripheral artery disease (PAD) Hemodialysis 147,37330.010.316.328.534.634.931.229.323.929.930.0 Peritoneal dialysis 11,18020.75.610.720.727.726.822.318.415.222.319.0 Transplant 23,46513.90.75.012.721.325.014.613.010.215.012.3 Atrial fibrillation (AFIB) Hemodialysis 147,37319.50.75.014.523.332.023.215.317.219.719.2 Peritoneal dialysis 11,18014.10.03.810.421.032.116.49.811.216.811.5 Transplant 23,46512.40.01.88.322.434.713.99.39.713.610.5 (Continued on next slide)

6. Table 9.1 Prevalence of cardiovascular diseases & procedures in ESRD patients, by treatment modality, age, race, & sex, 2013 (Continued) Vol 2, ESRD, Ch 96 Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients at all ages, with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2012. Abbreviations: AFIB, atrial fibrillation; AMI, acute myocardial infarction; ASHD, atherosclerotic heart disease; Af Am, African American; Blk, black; CABG, coronary artery bypass grafting; CHF, congestive heart failure; CKD, chronic kidney disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; CVD, cardiovascular disease; ICD/CRT-D, implantable cardioverter defibrillators/cardiac resynchronization therapy with defibrillator devices; PAD, peripheral arterial disease; PCI, percutaneous coronary interventions; SCA/VA, sudden cardiac arrest and ventricular arrhythmias. a The denominators for all cardiovascular comorbidities are patients described above by modality. b The denominators for PCI and CABG are patients with ASHD by modality. The denominator for ICD/CRT-D is patient with CHF by modality. # Patients % Patients Overall0-2122-4445-6465-7475+White Blk/Af Am OtherMaleFemale Cardiac arrest and ventricular arrhythmias (SCA/VA) Hemodialysis 147,3737.30.43.86.98.88.17.27.56.07.56.9 Peritoneal dialysis 11,1806.02.33.25.77.98.66.16.33.66.75.3 Transplant 23,4654.00.21.03.27.08.84.23.83.54.53.4 Cardiovascular Procedures b Revascularization – percutaneous coronary interventions (PCI) Hemodialysis60,125 5.30.04.86.35.44.05.64.76.35.45.2 Peritoneal dialysis3,578 6.20.05.46.17.35.36.85.33.16.06.4 Transplant5,228 5.20.05.67.04.42.65.44.55.55.44.8 Revascularization – coronary artery bypass graft (CABG) Hemodialysis60,125 1.80.02.22.51.80.71.7 2.42.01.4 Peritoneal dialysis3,578 2.60.02.92.8 2.02.72.52.23.41.6 Transplant5,228 2.00.02.02.51.7 2.11.53.12.0 Implantable cardioverter defibrillators & cardiac resynchronization therapy with defibrillator (ICD/CRT-D) Hemodialysis 54,7750.80.00.9 0.50.80.70.81.00.4 Peritoneal dialysis 2,8181.00.00.31.01.11.20.91.20.61.10.8 Transplant 4,3841.00.0 1.31.00.71.10.70.51.30.4

7. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: ASHD, atherosclerotic heart disease. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 97 (a)ASHD

8. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: AMI, acute myocardial infarction. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 98 (b) AMI

9. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: CHF, congestive heart failure. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 99 (c) CHF

10. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviations: CVA/TIA, cerebrovascular accident/transient ischemic attack. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 910 (d) CVA / TIA

11. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: PAD, peripheral arterial disease. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 911 (e) PAD

12. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: AFIB, atrial fibrillation. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 912 (f) AFIB

13. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviations: SCA/VA, sudden cardiac arrest and ventricular arrhythmias. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 913 (g) SCA / VA

14. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: PCI, percutaneous coronary interventions. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 914 (h) PCI

15. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: CABG, coronary artery bypass grafting. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 915 (i) CABG

16. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, and whose first ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2011. Abbreviation: ICD/CRT/D, implantable cardioverter defibrillators/cardiac resynchronization therapy with defibrillator devices. Figure 9.4 Probability of survival of ESRD patients with or without a cardiovascular disease or undergoing a cardiovascular procedure, 2011-2013 Vol 2, ESRD, Ch 916 (j) ICD / CRT / D

17. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis and peritoneal dialysis patients at all ages, with Medicare as primary payer on January 1, 2011, who are continuously enrolled in Medicare Parts A and B from July, 1, 2010 to December 31, 2010, ESRD service date is at least 90 days prior to January 1, 2011, and survived past 2012. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis. Table 9.2 Characteristics of patients with heart failure, by treatment modality, 2013 Vol 2, ESRD, Ch 917 Systolic +/- Diastolic heart failureDiastolic only heart failureHeart failure, unspecified HDPDHDPDHDPD N%N%N%N%N%N% Age 0-2170.010.110.00 110.060.5 22-448876.310012.47746.26311.21,8527.515613.2 45-645,04735.730337.54,41335.123141.29,29537.747440.1 65-744,03428.524129.83,56528.414225.36,64326.930726.0 75+4,17029.516420.33,81130.312522.36,85827.823820.2 Sex Male8,43159.647658.85,48443.626447.112,57351.061151.7 Female5,71440.433341.27,08056.429752.912,08649.057048.3 Race White7,70854.555568.66,54752.134461.312,72051.675563.9 Black/African American 5,75640.721626.75,38642.918733.310,68343.334429.1 Other6814.8384.76315.0305.31,2565.1826.9 Diabetes No4,02928.532339.93,50527.920336.27,09528.843937.2 Yes10,11671.548660.19,05972.135863.817,56471.274262.8