United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease.
United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease.
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DOI：
10.1038/kisup.2015.2
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发表时间：
2015-06
影响因子：
5.5
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中科院分区：
文献类型：
--
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美国肾脏数据系统 (USRDS) 于 1989 年通过美国国会根据美国国立卫生研究院竞争性合同授权启动。其历史包括五个合同期，两个合同期为 5 年，两个合同期为 7.5 年，第五个合同期于 2014 年 2 月授予，合同期为 5 年。在这 25 年里，USRDS 的报告从前两个合同期的终末期肾病 (ESRD) 的基本发病率和患病率、治疗方式和总体生存率以及对透析的重点特别研究转变为对后两个合同期影响发病率和死亡率的护理方面进行全面评估。从 1999 年开始，明尼阿波利斯医学研究基金会调查小组将 USRDS 转变为一个全面的护理报告系统，包括疾病严重程度、住院情况、儿科人群、处方药使用、慢性肾脏病以及向 ESRD 的过渡。重点领域包括与血液透析和腹膜透析患者治疗前 4 个月的死亡率、心源性猝死、缺血性和瓣膜性心脏病、充血性心力衰竭、心房颤动以及感染性并发症（特别是与透析导管相关）相关的问题；儿科透析和移植人群的充血性心力衰竭和感染并发症的负担；发病率和获得护理的机会。该团队记录了发病率的稳定和下降、自 2001 年以来死亡率下降 28%，以及 2011 年预期支付系统的变化，扩大了每次透析治疗的捆绑支付。该团队报告了计算死亡率的贝叶斯方法，该方法减少了传统方法的挑战，并介绍了《健康人 2010 年》和 2020 年国家肾病医疗保健目标的目标。
The United States Renal Data System (USRDS) began in 1989 through US Congressional authorization under National Institutes of Health competitive contracting. Its history includes five contract periods, two of 5 years, two of 7.5 years, and the fifth, awarded in February 2014, of 5 years. Over these 25 years, USRDS reporting transitioned from basic incidence and prevalence of end-stage renal disease (ESRD), modalities, and overall survival, as well as focused special studies on dialysis, in the first two contract periods to a comprehensive assessment of aspects of care that affect morbidity and mortality in the second two periods. Beginning in 1999, the Minneapolis Medical Research Foundation investigative team transformed the USRDS into a total care reporting system including disease severity, hospitalizations, pediatric populations, prescription drug use, and chronic kidney disease and the transition to ESRD. Areas of focus included issues related to death rates in the first 4 months of treatment, sudden cardiac death, ischemic and valvular heart disease, congestive heart failure, atrial fibrillation, and infectious complications (particularly related to dialysis catheters) in hemodialysis and peritoneal dialysis patients; the burden of congestive heart failure and infectious complications in pediatric dialysis and transplant populations; and morbidity and access to care. The team documented a plateau and decline in incidence rates, a 28% decline in death rates since 2001, and changes under the 2011 Prospective Payment System with expanded bundled payments for each dialysis treatment. The team reported on Bayesian methods to calculate mortality ratios, which reduce the challenges of traditional methods, and introduced objectives under the Health People 2010 and 2020 national health care goals for kidney disease.