- Email: [email protected]
Clinical Indicators and Preventive Care
Dialysis adequacy 100% (KDOQI target)
100% (KDOQI target)
Vascular access 100% (KDOQI target)
50% (KDOQI target)
Anemia mgmt
Diabetic care
Vaccinations
90%
90%
90%
90% (HP2020 target)
18.8% (2009)
51.8% (2009)
58.1% (2009)
17% (2009)
64.3% (2009)
Pts w/hb >12 g/dl
DM pts w/4+ A1c tests
DM pts w/2+ lipid tests
DM pts w/ comp. DM mon.
ESRD pts w/ 1 flu vaccin.
55.0% (2008) 50% (KDOQI target)
93.4% (2008)
94% (2009)
87.1% (2009)
30.8% (2008)
HD pts with delivered Kt/V ≥1.2
HD pts w/ URR ≥65%
CAPD pts with delivered Kt/V ≥1.7
New pts w/AV fistula as first access
77.2% (2009) Prev. pts w/ AVF as current access
Pts w/hb 10-12 g/dl
4.1% (2009) Pts w/hb <10 g/dl
25.8% (20082009) ESRD pts w/1 pneumonia vaccin.
22.1% (2009) ESRD pts w/1 hep B vaccin.
13+ Hemoglobin (g/dl)
>12-<13
60 40 9-<10 <9
20
Hemoglobin EPO
11
15
10
10
10-<11
0 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Hemoglobin (g/dl)
13 2005 2001
12
2009
11
1997 10 9 8 1
2
3
4
5
6
Mean wkly EPO dose (1,000s of units)
9 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
5
30 25 2009
2005
20 2001
15
1997
10 5 1
2
3
4
5
6
Months after initiation
Months after initiation
50
50 6 months
40 30
4-<6
20 10
2-<4
Percent of patients
20
11-12
Percent of patients
Percent of patients
80
12
Mean weekly EPO dose (1,000s of units)
100
40 30
2,700+ 1,200-<2,100 2,100-<2,700
20 0-<1,200 mg 10
0-<2 0
0 00 01 02 03 04 05 06 07 08 09
00 01 02 03 04 05 06 07 08 09
100
100
80 60 40 20
3 tests 2 tests 1 test
4+ tests Percent of patients
Percent of patients
4+ tests 80
3 tests 60 2 tests 40 1 test 20
% with comprehensive monitoring
No tests
No tests
0
0
96-97 98-99 00-01 02-03 04-05 06-07 08-09
96-97 98-99 00-01 02-03 04-05 06-07 08-09
20
15
10
5
0 96-97 98-99 00-01 02-03 04-05 06-07 08-09
80
Percent of patients
Catheter
60 AV fistula Catheter w/maturing fistula
40
AV graft Catheter w/maturing graft
20
0 2005
2006
2007
2008
2009
80
Dialysis All White African American Asian Other Hispanic
60
Percent of patients
40
20
0 80
Transplant
60
40
20
0 A
B
C
D
E
F
G
H
I
Percent of patients
60
Dialysis
Transplant All White African American Asian Other Hispanic
40
20
0 A
C
D
E
F
Dialysis
A
B
C
D
E
F
Transplant
100
All White African American Asian Other Hispanic
10
5
Percent of patients
Percent of patients
15
B
0
Percent of patients
80
Dialysis
Calcitriol Paricalcitol Inactivated Doxercalciferol vitamin D
Transplant All White African American Asian Other Hispanic
60 40 20 0 A
B
C
D
E
F
G
A
B
C
D
E
F
G
Asian Other Hispanic
60 40 20 0
Calcitriol Paricalcitol Inactivated Doxercalciferol vitamin D
All White Af Am
80
Any
Sev- Calcium Lanth- Comb. ≥1 elemer acetate anum month
100% (KDOQI target)
Vascular access 100% (KDOQI target)
50% (KDOQI target)
Anemia mgmt
Diabetic care
Vaccinations
90%
90%
90%
90% (HP2020 target)
18.8% (2009)
51.8% (2009)
58.1% (2009)
17% (2009)
64.3% (2009)
Pts w/hb >12 g/dl
DM pts w/4+ A1c tests
DM pts w/2+ lipid tests
DM pts w/ comp. DM mon.
ESRD pts w/ 1 flu vaccin.
55.0% (2008) 50% (KDOQI target)
93.4% (2008)
94% (2009)
87.1% (2009)
30.8% (2008)
HD pts with delivered Kt/V ≥1.2
HD pts w/ URR ≥65%
CAPD pts with delivered Kt/V ≥1.7
New pts w/AV fistula as first access
77.2% (2009) Prev. pts w/ AVF as current access
Pts w/hb 10-12 g/dl
4.1% (2009) Pts w/hb <10 g/dl
25.8% (20082009) ESRD pts w/1 pneumonia vaccin.
22.1% (2009) ESRD pts w/1 hep B vaccin.
13+ Hemoglobin (g/dl)
>12-<13
60 40 9-<10 <9
20
Hemoglobin EPO
11
15
10
10
10-<11
0 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Hemoglobin (g/dl)
13 2005 2001
12
2009
11
1997 10 9 8 1
2
3
4
5
6
Mean wkly EPO dose (1,000s of units)
9 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
5
30 25 2009
2005
20 2001
15
1997
10 5 1
2
3
4
5
6
Months after initiation
Months after initiation
50
50 6 months
40 30
4-<6
20 10
2-<4
Percent of patients
20
11-12
Percent of patients
Percent of patients
80
12
Mean weekly EPO dose (1,000s of units)
100
40 30
2,700+ 1,200-<2,100 2,100-<2,700
20 0-<1,200 mg 10
0-<2 0
0 00 01 02 03 04 05 06 07 08 09
00 01 02 03 04 05 06 07 08 09
100
100
80 60 40 20
3 tests 2 tests 1 test
4+ tests Percent of patients
Percent of patients
4+ tests 80
3 tests 60 2 tests 40 1 test 20
% with comprehensive monitoring
No tests
No tests
0
0
96-97 98-99 00-01 02-03 04-05 06-07 08-09
96-97 98-99 00-01 02-03 04-05 06-07 08-09
20
15
10
5
0 96-97 98-99 00-01 02-03 04-05 06-07 08-09
80
Percent of patients
Catheter
60 AV fistula Catheter w/maturing fistula
40
AV graft Catheter w/maturing graft
20
0 2005
2006
2007
2008
2009
80
Dialysis All White African American Asian Other Hispanic
60
Percent of patients
40
20
0 80
Transplant
60
40
20
0 A
B
C
D
E
F
G
H
I
Percent of patients
60
Dialysis
Transplant All White African American Asian Other Hispanic
40
20
0 A
C
D
E
F
Dialysis
A
B
C
D
E
F
Transplant
100
All White African American Asian Other Hispanic
10
5
Percent of patients
Percent of patients
15
B
0
Percent of patients
80
Dialysis
Calcitriol Paricalcitol Inactivated Doxercalciferol vitamin D
Transplant All White African American Asian Other Hispanic
60 40 20 0 A
B
C
D
E
F
G
A
B
C
D
E
F
G
Asian Other Hispanic
60 40 20 0
Calcitriol Paricalcitol Inactivated Doxercalciferol vitamin D
All White Af Am
80
Any
Sev- Calcium Lanth- Comb. ≥1 elemer acetate anum month