Table 2.
Ten-year trends in the cause of ESRD and comorbidity, body mass index, laboratory and initial dialysis modality status characteristics by insurance group
| Payer status | Medicaid | Medicare alone | Medicare comb.a | DVAb | Private | Other | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Years | 1995–96 | 2003–04 | 1995–96 | 2003–04 | 1995–96 | 2003–04 | 1995–96 | 2003–04 | 1995–96 | 2003–04 | 1995–96 | 2003–04 |
| Cause of ESRD | ||||||||||||
| Diabetes | 50.4% | 52.2%† | 43.6% | 46.6%† | 38.8% | 41.7%† | 41.4% | 52.5%† | 40.1% | 41.6% | 39.5% | 41.7%† |
| Hypertension | 22.2% | 24.5%† | 26.7% | 28.6%† | 25.5% | 28.6%† | 23.9% | 19.8%* | 17.9% | 19.0%† | 24.1% | 25.9%† |
| Immune | 11.4% | 8.2%† | 10.0% | 6.5%† | 11.7% | 7.5%† | 14.6% | 7.5%† | 21.5% | 18.5%† | 15.7% | 13.2%† |
| Other | 16.0% | 15.2%* | 19.7% | 18.3%† | 24.1% | 22.2%† | 20.1% | 20.2% | 20.6% | 20.9% | 20.7% | 19.3%† |
| Comorbidities | ||||||||||||
| Diabetes | 51.6% | 54.4%† | 44.7% | 49.0%† | 40.4% | 44.3%† | 42.4% | 55.5%† | 41.0% | 43.3%† | 40.4% | 43.1%† |
| Hypertension | 75.3% | 84.2%† | 72.9% | 84.4%† | 74.7% | 84.2%† | 75.6% | 85.9%† | 73.2% | 83.0%† | 68.7% | 82.8%† |
| Heart failure | 33.0% | 33.1% | 36.1% | 37.2% | 40.3% | 40.3% | 24.5% | 25.8% | 21.6% | 19.0%† | 22.9% | 24.1% |
| CAD | 21.6% | 24.1%† | 29.2% | 33.2%† | 35.8% | 39.9%† | 24.3% | 27.4% | 16.0% | 15.7% | 16.7% | 17.4% |
| PVD | 13.8% | 14.0% | 16.9% | 17.3% | 19.2% | 19.1% | 15.2% | 13.6% | 8.6% | 7.7%† | 9.7% | 8.7%† |
| CVA | 9.6% | 10.5%† | 10.0% | 11.5%† | 10.6% | 11.4%† | 11.1% | 8.9% | 4.8% | 4.7% | 5.5% | 5.6% |
| Dysrhythmia | 4.5% | 4.8%* | 7.1% | 7.8%† | 8.9% | 10.7%† | 4.8% | 4.6% | 2.8% | 3.0% | 3.2% | 3.6% |
| Body mass index | ||||||||||||
| <20 kg/m2 | 17.6% | 10.8%† | 16.1% | 10.6%† | 15.0% | 9.5%† | 17.5% | 8.8%† | 13.7% | 6.3%† | 14.9% | 9.1%† |
| 20–24.99 kg/m2 | 29.8% | 29.8% | 32.6% | 32.2% | 34.6% | 34.0% | 31.0% | 30.1% | 29.7% | 26.2%† | 27.6% | 31.7%† |
| 25–29.99 kg/m2 | 20.6% | 25.9%† | 21.6% | 28.8%† | 23.1% | 30.0%† | 20.0% | 32.3%† | 23.2% | 29.0%† | 19.3% | 28.1%† |
| +30 kg/m2 | 19.5% | 32.3%† | 14.3% | 27.6%† | 13.7% | 25.8%† | 14.1% | 27.7%† | 19.8% | 37.6%† | 15.3% | 30.1%† |
| Haemoglobin | ||||||||||||
| <11.0 g/dL | 70.5% | 68.6%† | 64.2% | 67.1%† | 62.1% | 62.9% | 66.2% | 63.0% | 66.9% | 64.1%† | 65.5% | 69.7%† |
| ≥11.0 g/dL | 12.3% | 24.0%† | 13.4% | 25.7%† | 15.9% | 29.6%† | 13.0% | 27.6%† | 15.3% | 27.3%† | 13.2% | 23.5%† |
| Dialysis modality | ||||||||||||
| In-centre HD | 90.9% | 95.5%† | 88.9% | 94.7%† | 86.0% | 93.2%† | 87.2% | 95.1%† | 76.6% | 85.0%† | 80.1% | 92.3%† |
| Home HD | 0.4% | 0.3% | 0.8% | 0.7% | 0.6% | 0.4%† | 0.7% | ‡ | ‡ | 0.3%† | 2.6% | 0.3%† |
| PD | 8.8% | 4.2%† | 10.4% | 4.7%† | 13.4% | 6.4%† | 12.1% | ‡ | ‡ | 14.7%† | 17.3% | 7.3%† |
aMedicare combined group consists of Medicare plus any additional non-Medicaid insurance.
bDVA, Department of Veterans Affairs.
*10-year trend from 1995 to 2004 significant within payer group, P < 0.01.
†10-year trend from 1995 to 2004 significant within payer group, P < 0.001.
‡Not reportable due to Centres for Medicare & Medicaid restrictions on cell sizes.
CAD, coronary artery disease; PVD, peripheral vascular disease; CVA, cerebrovascular accident; HD, haemodialysis; PD, peritoneal dialysis.
Characteristics shown as a percentage, unless otherwise noted.
Because of missing values for body mass index and haemoglobin, totals do not add to 100% in these categories.