Centers for Disease Control Debuts CKD Surveillance System

Chronic kidney disease (CKD) is a growing public health problem affecting 10–15 percent of the general U.S. population. Yet until recently, the United States lacked a comprehensive surveillance system to document the burden of CKD and its risk factors over time. To address this need, the Centers for Disease Control and Prevention (CDC), as a major part of its CKD Initiative, commissioned two research teams led by Neil Powe, MD, at the University of California, San Francisco, and Rajiv Saran, MD, of the University of Michigan to develop and implement a national CKD Surveillance System. The surveillance system was successfully launched in the fall of 2012 and is currently available on the CDC’s website at www.cdc.gov/ckd/surveillance.

The surveillance system tracks “the progress of our efforts to prevent, detect, and manage CKD,” the CDC writes on the website. It also “provides the means for evaluating, monitoring, and implementing quality improvement efforts by both federal and nonfederal agencies.” Highlights of the surveillance system include a national CKD fact sheet and a specific section to evaluate progress toward achieving Healthy People 2020 objectives for CKD.

Data is arranged within categories, so that specific indicators, such as “percentage of patients seeing a nephrologist by stage,” are nested within broader topics, such as “processes and quality of care in CKD.” There are currently nine broad topics: incidence, prevalence, awareness, burden of risk factors, health consequences, processes and quality of care, health care system capacity, CKD in children and adolescents, and CKD in the solid organ transplant population. Each broad topic contains multiple indicators. Tables and figures are downloadable.

“What’s novel about this surveillance system is that it brings CKD data from disparate data sources together into one location,” Powe said. “Integration of multiple data sources is one of the main goals of this project, enabling us to help provide a complete picture of national trends in CKD.”

The current surveillance system contains data from many resources, including measures derived from the National Health and Nutrition Examination Surveys (NHANES), the Veterans Affairs Healthcare System (National VA), the United States Renal Data System (USRDS), the National Kidney Disease Education Program (NKDEP), the College of American Pathologists (CAP), and the American Medical Association (AMA), to name a few. Data sources are rigorously evaluated for characteristics that would make them useful to include in a surveillance system, including representativeness and stability over time.

“Key goals of this surveillance system are to monitor trends, promote CKD prevention and stimulate improvement of CKD care,” Powe said. “We’re hoping to disseminate the data as widely as possible so that it may be used to its fullest public health potential.”