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Primary Cause of Kidney Failure in new ESRD patients at initiation, by ethnicity figure 2.1, 1997-2000 combined.

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Presentation on theme: "Primary Cause of Kidney Failure in new ESRD patients at initiation, by ethnicity figure 2.1, 1997-2000 combined."— Presentation transcript:

1 Primary Cause of Kidney Failure in new ESRD patients at initiation, by ethnicity figure 2.1, combined

2 Percent of new patients with diabetes as the primary cause of renal failure figure 2.2, combined, by HSA, unadjusted Percent of patients 47.8+ (52.0) 45.5 to <47.8 43.9 to <45.5 42.2 to <43.9 below 42.2 (40.5)

3 Cardiovascular comorbidity at initiation: diabetics figure 2
Cardiovascular comorbidity at initiation: diabetics figure 2.3, 2000, by HSA, unadjusted Percent of patients 43.8+ (48.7) 39.7 to <43.8 36.8 to <39.7 33.5 to <36.8 below 33.5 (29.8)

4 Cardiovascular comorbidity at initiation: non-diabetics figure 2
Cardiovascular comorbidity at initiation: non-diabetics figure 2.3, 2000, by HSA, unadjusted Percent of patients 34.0+ (37.2) 30.1 to <34.0 26.2 to <30.1 24.0 to <26.2 below 24.0 (21.8)

5 Trends in cardiovascular comorb
Trends in cardiovascular comorb. from inpatient hospitalization diagnosis codes, in patients surviving one-year after ESRD figure 2.4, incident ESRD patients

6 Trends in cardiovascular comorb
Trends in cardiovascular comorb. developed in the two years prior to dialysis, patients 67 years & older figure 2.5, incident ESRD patients

7 Trends in the number of comorbid conditions at initiation figure 2
Trends in the number of comorbid conditions at initiation figure 2.6, incident ESRD patients

8 Trends in the occurrence of diabetes as a primary or secondary complication, by race/ethnicity figure 2.7, incident ESRD patients All White Black Percent of patients

9 Trends in the occurrence of diabetes as a primary or secondary complication, by race/ethnicity figure 2.7, incident ESRD patients Native American Asian Hispanic Percent of patients

10 % of pts at initiation with serum albumin < test’s lower limit, by age& gender figure 2.8, incident ESRD patients Age Gender

11 % of pts at initiation with serum albumin < test’s lower limit, by race, & primary diagnosis figure 2.8, incident ESRD patients (cont.) Race Primary diagnosis Percent of patients

12 Geographic variations in the % of patients at initiation with albumin levels below the test’s lower limit: 1995 figure 2.9, incident ESRD patients, by HSA, unadjusted Percent of patients 64.3+ (66.1) 62.9 to <64.3 58.5 to 62.9 56.8 to <58.5 below 56.8 (55.7)

13 Geographic variations in the % of patients at initiation with albumin levels below the test’s lower limit: 2000 figure 2.9, incident ESRD patients, by HSA, unadjusted Percent of patients 64.3+ (65.2) 62.9 to <64.3 58.5 to <62.9 56.8 to <58.5 below 56.8 (NA)

14 Geographic variations in the % of pts at initiation with allbumin levels < the test’s lower limit: % change figure 2.9, incident ESRD patients, by HSA, unadjusted Percent change 14.2+ (16.2) 11.9 to <14.2 10.2 to 11.9 9.0 to <10.2 below 9.0 (7.8)

15 Trends in EPO use prior to initiation, by age & gender figure 2
Trends in EPO use prior to initiation, by age & gender figure 2.10, incident ESRD patients

16 Trends in EPO use prior to initiation, by race/ethnicity & gender figure 2.11, incident ESRD patients

17 Trends in mean hemoglobin at initiation, by EPO treatment figure 2
Trends in mean hemoglobin at initiation, by EPO treatment figure 2.12, incident ESRD patients

18 Geographic variations in the percent of patients receiving EPO prior to initiation, by race: all figure 2.13, combined, incident ESRD patients, by HSA, unadjusted Percent of patients 34.7+ (41.8) 28.8 to <34.7 24.2 to <28.8 19.6 to <24.2 below 19.6 (16.4)

19 Geographic variations in the percent of patients receiving EPO prior to initiation, by race: white figure 2.13, combined, incident ESRD patients, by HSA, unadjusted Percent of patients 34.7+ (41.3) 28.8 to <34.7 24.2 to <28.8 19.6 to <24.2 below 19.6 (17.1)

20 Geographic variations in the % of pts receiving EPO prior to initiation, by race: non-white figure 2.13, combined, incident ESRD patients, by HSA, unadjusted Percent of patients 34.7+ (41.2) 28.8 to <34.7 24.2 to <28.8 19.6 to <24.2 below 19.6 (16.4)

21 Trends in hemoglobin level from the Medical Evidence Form 2728 at initiation figure 2.14, incident ESRD patients

22 Trends in mean hemoglobin at initiation, by age & gender figure 2
Trends in mean hemoglobin at initiation, by age & gender figure 2.15, incident ESRD patients

23 Trends in mean hemoglobin at initiation, by race/ethnicity & gender figure 2.16, incident ESRD patients

24 Trends in mean hemoglobin at initiation, by modality figure 2
Trends in mean hemoglobin at initiation, by modality figure 2.17, incident ESRD patients

25 Geographic variations in mean hemoglobin at initiation: all figure 2
Geographic variations in mean hemoglobin at initiation: all figure 2.18, combined, incident ESRD patients, by HSA, unadjusted Mean hemoglobin (g/dl) 10.0+ (10.1) 9.8 to <10.0 9.7 to <9.8 9.6 to <9.7 below 9.6 (9.5)

26 Geographic variations in mean hemoglobin at initiation: white figure 2
Geographic variations in mean hemoglobin at initiation: white figure 2.18, combined, incident ESRD patients, by HSA, unadjusted Mean hemoglobin (g/dl) 10.0+ (10.2) 9.8 to <10.0 9.7 to <9.8 9.6 to <9.7 below 9.6 (9.4)

27 Geographic variations in mean hemoglobin at initiation: non-white figure 2.18, combined, incident ESRD patients, by HSA, unadjusted Mean hemoglobin (g/dl) 10.0+ (10.3) 9.8 to <10.0 9.7 to <9.8 9.6 to <9.7 below 9.6 (9.5)

28 Geographic variations in mean BUN at initiation: 2000 figure 2
Geographic variations in mean BUN at initiation: 2000 figure 2.19, incident ESRD patients, by HSA, unadjusted Mean BUN (mg/dl) 89.1+ (92.0) 87.4 to <89.1 85.9 to <87.4 84.4 to <85.9 below 84.4 (81.5)

29 Geographic variations in mean BUN at initiation, percent change : figure 2.19, incident ESRD patients, by HSA, unadjusted Percent change -5.3+ (-3.2) -6.5 to <-5.3 -7.9 to <-6.5 -9.7 to <-7.9 below -9.7 (-13.0)

30 Trends in mean BUN at initiation, by age & race/ethnicity figure 2
Trends in mean BUN at initiation, by age & race/ethnicity figure 2.20, incident ESRD patients

31 Geographic variations in mean serum creatinine at initiation figure 2
Geographic variations in mean serum creatinine at initiation figure 2.21, incident ESRD patients, by HSA, unadjusted Serum creatinine (mg/dl) 7.59+ (7.94) 7.31 to <7.59 7.00 to <7.31 6.72 to <7.00 below 6.72 (6.49)

32 Geographic variations in mean serum creatinine at initiation, % change: figure 2.21, incident ESRD patients, by HSA, unadjusted Percent change (-8.5) -14.3 to <-11.3 -16.7 to <-14.3 -19.5 to <-16.7 below (-21.9)

33 Trends in mean serum creatinine at initiation, by age & race/ethnicity figure 2.22, incident ESRD patients

34 Geographic variations in mean eGFR at initiation: 2000 figure 2
Geographic variations in mean eGFR at initiation: 2000 figure 2.23, incident ESRD patients, by HSA, unadjusted eGFR (ml/min) 8.91+ (9.25) 8.57 to <8.91 8.38 to <8.57 8.22 to <8.38 below 8.22 (8.03))

35 Geographic variations in mean eGFR at initiation, % change: figure 2.23, incident ESRD patients, by HSA, unadjusted Percent change 22.8+ (27.4) 20.0 to <22.8 18.0 to <20.0 15.9 to <18.0 below 15.9 (13.5)

36 Trends in mean eGFR at initiation, by age & race/ethnicity figure 2.24

37 Geographic variations in mean BMI at initiation: 2000 figure 2
Geographic variations in mean BMI at initiation: 2000 figure 2.25, incident ESRD patients, by HSA, unadjusted BMI (kg/m2) 27.0+ (27.2) 26.9 to <27.0 26.8 to <26.9 26.7 to <26.8 below 26.7 (26.5)

38 Geographic variations in mean BMI at initiation, % change: figure 2.25, incident ESRD patients, by HSA, unadjusted Percent change 7.15+ (9.69) 5.73 to <7.15 4.57 to <5.73 3.05 to <4.57 below 3.05 (0.53)

39 Trends in mean BMI at initiation, by age & race/ethnicity figure 2
Trends in mean BMI at initiation, by age & race/ethnicity figure 2.26, incident ESRD patients

40 BMI distribution in Patients with a history of cardiovascular disease & stroke figure 2.27 by age, race and ethnicity

41 BMI distribution in Patients with a history of cardiovascular disease & stroke figure 2.28 by age, race and ethnicity

42 Differences in eGFR at initiation, by age, race/ethnicity, diabetic status, & gender figure 2.29

43 Differences in eGFR at initiation, by age, race/ethnicity, diabetic status, & gender figure 2.29 (con.t) Non-diabetics

44 Differences in eGFR at initiation, by pre-ESRD hospital days, age, & gender, patients 67 & older figure 2.30

45 Differences in eGFR at initiation, by Charlson score, & age, patients 67 & older figure 2.31

46 Differences in eGFR at initiation, by Charlson score, & gender, patients 67 & older figure 2.31 (cont.)

47 Event curves for first hospitalization in the first year of ESRD, by eGFR at initiation figure 2.32, incident dialysis patients, combined

48 Event curves for survival in the first year of ESRD, by eGFR at initiation figure 2.33, incident dialysis patients, combined

49 Percent survival, by eGFR at initiation & race figure 2
Percent survival, by eGFR at initiation & race figure 2.34, incident dialysis patients, combined

50 Percents receiving EPO before initiation, by race/ethnicity & insurance coverage figure 2.35, incident ESRD patients, 2000 Percent of patients All W B NA A H All W B NA A H All W B NA A H All W B NA A H

51 Percents receiving EPO before initiation, by race/ethnicity & insurance coverage figure 2.35, incident ESRD patients, 2000 (cont.) Percent of patients

52 Mean hemoglobin at initiation, by race/ethnicity & insurance coverage figure 2.36, incident ESRD patients, 2000 Hemoglobin g/dl All W B NA A H All W B NA A H All W B NA A H All W B NA A H

53 Mean hemoglobin at initiation, by race/ethnicity & insurance coverage figure 2.36, incident ESRD patients, 2000 (cont.) Hemoglobin g/dl

54 Patients with cardiovascular disease at initiation, by race/ethnicity & insurance coverage figure 2.37, incident ESRD patients, 2000 Percent of patients All W B NA A H All W B NA A H All W B NA A H All W B NA A H

55 Patients with cardiovascular disease at initiation, by race/ethnicity & insurance coverage figure 2.37, incident ESRD patients, 2000 (cont.) Percent of patients

56 Racial & ethnic distribution, by insurance type at initiation figure 2
Racial & ethnic distribution, by insurance type at initiation figure 2.38, incident ESRD patients, 2000 Percent of patients Insurance groups M/caid-Medicaid only M/care-Medicare only M w/oth-Medicare with other M & M-Medicare & Medicaid M + EGHP-Medicare with EGHP DVA/oth-DVA or other EGHP-EGHP only None-no insurance M/caid M/care M w/oth M & M M + EGHP DVA/oth EHGP None Insurance type (see table above for codes)

57 Racial & ethnic distribution, by insurance type at initiation figure 2
Racial & ethnic distribution, by insurance type at initiation figure 2.38, incident ESRD patients, 2000 (cont.) Hispanic ethnicity Percent of patients Insurance groups M/caid-Medicaid only M/care-Medicare only M w/oth-Medicare with other M & M-Medicare & Medicaid M + EGHP-Medicare with EGHP DVA/oth-DVA or other EGHP-EGHP only None-no insurance Insurance type (see table above for codes)

58 Geographic variations in the percent of patients with insurance at initiation: Medicaid only figure 2.39, incident ESRD patients, 2000, by HSA, unadjusted Percent of patients (12.79) 9.32 to <11.04 7.82 to <9.32 7.00 to <7.82 below 7.00 (6.49)

59 Geographic variations in the percent of patients with insurance at initiation: Medicare only figure 2.39, incident ESRD patients, 2000, by HSA, unadjusted Percent of patients 16.9+ (19.3) 14.7 to <16.9 12.7 to <14.7 10.4 to <12.7 below 10.4 (9.2)

60 Geographic variations in the percent of patients with insurance at initiation: Medicare with other figure 2.39, incident ESRD patients, 2000, by HSA, unadjusted Percent of patients 33.2+ (39.6) 26.2 to <33.2 20.7 to <26.2 15.6 to <20.7 below 15.6 (13.0))

61 Geographic variations in the % of patients with insurance at initiation: Medicare with Medicaid figure 2.39, incident ESRD patients, 2000, by HSA, unadjusted Percent of patients 15.6+ (19.5) 11.9 to <15.6 10.0 to <11.9 8.7 to <10.0 below 8.7 (7.8)

62 Geographic variations in the percent of patients with insurance at initiation: Medicare with EGHP figure 2.39, incident ESRD patients, 2000, by HSA, unadjusted Percent of patients 8.64+ (13.60) 6.41 to <8.64 5.08 to <6.41 3.79 to <5.08 below 3.79 (3.20)

63 Geographic variations in the % of patients with insurance at initiation: DVA or other figure 2.39, incident ESRD patients, 2000, by HSA, unadjusted Percent of patients (15.80) 10.13 to <12.76 8.59 to <10.13 7.00 to <8.59 below 7.00 (6.00)


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