Average monthly counts of incident ESRD patients initiating on dialysis in freestanding facilities increased steadily between 1996 and 2010, reaching a peak of more than 8,000 patients per month in 2009 and 2010. In 2011 the average monthly count actually declined, albeit by only slightly more than 1 percent. While it is uncertain whether this decline might represent an aberration due to recent economic weakness or portend a robust downturn in the incidence of Stage 5 CKD, the increasing age of the U.S. population, and the rising prevalence of diabetes, suggests that the former is more likely.
Interestingly, average monthly counts of incident patients exhibit substantial seasonality, with those during the first quarter of recent years exceeding those during the third quarter by roughly 15 percent. This pattern may be due to broadly increased use of healthcare resources during the winter season, resulting in the detection of previously undiagnosed Stage 5 CKD. That more patients begin dialysis during the first quarter, a period marked by substantial risk of communicable disease, will be an ongoing challenge for dialysis providers.
Incident Counts by Month, Quarter, & Year
Incident Counts, by U.S. Census Division
Incident counts in 2011 were 1.8 times higher than those recorded in 1996.
The South Atlantic Census Division had the highest number of incident patients in 2011 at 21,875.
Counts of incident ESRD cases initiating on dialysis in freestanding facilities
First outpatient dialysis session within three months of chronic dialysis initiation.
APC, Annual Percent Change. Maps show 2011 counts.