Chi-yuan Hsu, MD, MSc; Eric Vittinghoff, PhD; Feng Lin, MS; Michael G. Shlipak, MD, MPH
Acknowledgments: The authors thank Dr. Ann O'Hare, Dr. Charles McCulloch, and Ms. Michelle Odden for their assistance.
Disclaimer: Some of the data reported here were supplied by the U.S. Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the United States government.
Grant Support: By the National Institutes of Health (grants DK61520 [Dr. Hsu] and HL68099 [Dr. Shlipak]). Dr. Shlipak was also supported by the Health Services Research and Development Service of the Veterans Affairs Administration (Advanced Research Career Development Award), American Federation for Aging Research (Paul Beeson Scholars Program), and Robert Wood Johnson Foundation (Generalist Scholars Program).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Chi-yuan Hsu, MD, MSc, Division of Nephrology, University of California, San Francisco, 513 Parnassus Avenue, 672 HSE, Box 0532, San Francisco, CA 94143-0532; e-mail, email@example.com.
Current Author Addresses: Dr. Hsu: Division of Nephrology, University of California, San Francisco, 513 Parnassus Avenue, 672 HSE, Box 0532, San Francisco, CA 94143-0532.
Dr. Vittinghoff: University of California, San Francisco, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115.
Ms. Lin: University of California, San Francisco, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105.
Dr. Shlipak: Veterans Affairs Medical Center, 4150 Clement Street (111A1), San Francisco, CA 94121.
Author Contributions: Conception and design: C.Y. Hsu, M.G. Shlipak.
Analysis and interpretation of the data: C.Y. Hsu, E. Vittinghoff, F. Lin, M.G. Shlipak.
Drafting of the article: C.Y. Hsu, M.G. Shlipak.
Critical revision of the article for important intellectual content: C.Y. Hsu, E. Vittinghoff, F. Lin, M.G. Shlipak.
Final approval of the article: C.Y. Hsu, E. Vittinghoff, F. Lin, M.G. Shlipak.
Statistical expertise: C.Y. Hsu, E. Vittinghoff, F. Lin.
Obtaining of funding: C.Y. Hsu, M.G. Shlipak.
Hsu C., Vittinghoff E., Lin F., Shlipak M.; The Incidence of End-Stage Renal Disease Is Increasing Faster than the Prevalence of Chronic Renal Insufficiency. Ann Intern Med. 2004;141:95-101. doi: 10.7326/0003-4819-141-2-200407200-00007
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Published: Ann Intern Med. 2004;141(2):95-101.
The causes of the rapid growth in incidence of end-stage renal disease (ESRD) are unknown but may include an increase in prevalence of renal disease; more liberal acceptance into ESRD therapy; or improved survival from competing causes of death, such as cardiovascular disease.
Comparison of data from the Second and Third National Health and Nutrition Examination Surveys and the U.S. Renal Data System shows that the increase in ESRD cannot be explained by increasing prevalence of chronic renal insufficiency.
Interventions aimed at the primary and secondary prevention of kidney disease alone are unlikely to reduce the increase in incidence of ESRD.
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