Concept: End Stage Kidney Disease (ESKD)

Introduction

This concept defines end stage kidney disease (ESKD) as it was used in the Care of Manitobans Living with Chronic Kidney Disease deliverable by Chartier et al. (2015). This includes the age groups applied, the data sources for this definition, the code values and conditions identifying end stage kidney disease, and any additional conditions / restrictions that are applied.

"Chronic kidney disease (CKD) is a general term for heterogeneous disorders affecting kidney structure and function. CKD was previously perceived as a life-threatening condition affecting a small number of people, but it is now thought of as a common disorder requiring a public health strategy (Levey & Coresh, 2012). CKD encompasses disorders that damage the glomeruli (kidney filters) and lead to gradual long-term loss of kidney function. End stage kidney disease (ESKD) or kidney failure is the last and most debilitating stage of CKD." (Chartier et al. (2015).

NOTE: Previous MCHP research into this topic refers to it as "renal failure". For more information on this previous research, please read the Renal Failure concept.

Technical Definition of End Stage Kidney Disease

The technical definition of end stage kidney disease used in Chartier et al. (2015) is as follows:


• Age Groups:
  
  • Children: 0-17 years old as of dialysis start or transplant date
    
  • Adults: 18 years and older as of dialysis start or transplant date
  
  
• Data Sources:
  
  • Renal Pediatrics Demographics File from the Manitoba Pediatric Chronic Kidney Disease Registry;
    
  • Manitoba Renal Program (MRP) data;
    
  • Hospital Abstracts data; and the
    
  • Medical Services (Physician Claims) data
  
  
• Code Values and Conditions: - defined as Manitoba residents receiving dialysis or kidney transplant April 1, 1999 – March 31, 2012 using the following physician tariff and ICD codes and conditions:
  
  
  • dialysis for 90 days or until death with no gaps > 15 days between sessions (physician tariff codes: 3792, 3790, 3793, 3794, 3800, 3801, 3803, 3804, 3805, 9610, 9798, 9799, 9801, 9802, 9805, 9806, 9807, 9814, 9819, 9820, 9821) from the Medical Services data; or
    
  • at least 1 physician claim for kidney transplant (ICD-9-CM procedure: 55.6; tariff: 5883) from the Hospital Abstracts data or the Medical Services data; or
    
  • at least 1 hospitalization for kidney transplant (CCI intervention codes: 1PC85, 1OK85) from the Hospital Abstracts data
  
  
• Conditions / Restrictions:
  
  • Dialysis in children is restricted to children listed in the Renal Pediatrics Demographics File.

End Stage Kidney Disease Incidence and Prevalence

To calculate the incidence of ESKD, they counted the number of new cases of ESKD in a given time period and divided it by the number of people living in Manitoba in the same period.

The prevalence was calculated in a similar way: the number of existing cases of ESKD in a given time period divided by the number of people living in Manitoba at that time. This was calculated for the child and adult populations. For regional rates, incidence and prevalence were adjusted by age and sex to account for differences in age and sex distribution in the regions.

For information on the results of ESKD incidence and prevalence calculations, please see Chapter 3 Key Findings in the deliverable.