1. Figure 1.1 Identification of new patients in freestanding dialysis facilities Dialysis patients, 2013
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2. Figure 1.2 Incidence rates, overall and by US Census Division Patients aged 18 years or older; (% change 2000 to 2013).
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3. Figure 1.3 Prevalent rates, overall and by US Census Division Patients aged 18 years or older; (% change 2000 to 2013).
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4. Figure 1.4 Incidence counts, by month and year Patients aged 18 years or older.
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5. Figure 1.5 Incidence counts, by US Census Division Patients aged 18 years or older.
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6. Figure 1.6 Prevalence counts, by month and year Patients aged 18 years or older.
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7. Figure 1.7 Prevalence counts, by US Census Division Patients aged 18 years or older.
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8. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 1, New England Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 1 ● New England
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities have been relatively stable in New England overall since 2004.
Massachusetts has been the division leader in incident cases, and counts changed little through 2013.
Most dialysis facilities in Vermont are hospital based, resulting in few incident patients in freestanding facilities (based on data from the End-Stage Renal Disease Network of New England,
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9. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 2, Mid Atlantic Patients aged 18 years or older. APC annual percent change. Map shows counts
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities increased the most among all census divisions in the Middle Atlantic division, with an annual percent change of 2.9.
New Jersey led the division with an annual percent change of 4.8 and a 60.8% increase in counts from 2004 to 2013.
The increase in New York was only slightly less than in New Jersey, with an annual percent change of 4.1.
Division 2 ● Mid Atlantic
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10. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 3, East North Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 3 ● East North Central
The East North Central division is complex, with major population centers (e.g., Chicago, Detroit, and Cincinnati), wide rural expanses (e.g., Illinois, Indiana, and Wisconsin), and challenging socioeconomics in the Ohio River Valley basin.
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities increased by an annual percent change of 2.0 in the East North Central division, but trends varied somewhat across states.
Counts increased most rapidly in Indiana and Illinois.
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11. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 1, New England Patients aged 18 years or older. APC annual percent change. Map shows counts
The overall annual percent increase in prevalent patient counts in the New England division was 3.2 from 2004 through 2013.
Massachusetts accounted for almost half of the prevalent population in this division, and counts were smallest in Vermont.
Division 1 ● New England
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12. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 2, Mid Atlantic Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 2 ● Mid Atlantic
New Jersey led growth in prevalent patient counts in the Middle Atlantic division, with an annual percent change of 6.3 from 2004 through 2013.
Growth was slowest in Pennsylvania, with an annual percent change of 3.6.
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13. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 3, East North Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Prevalent patient counts increased steadily in all states in the East North Central division from 2004 through 2013.
Growth was strongest in Wisconsin (annual percent change 5.2), and slowest in Michigan (annual percent change 3.7).
Division 3 ● East North Central
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14. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 4, West North Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 4 ● West North Central
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities increased only modestly in the West North Central division.
Annual counts in North Dakota increased dramatically between 2007 and 2009, as new freestanding facilities opened (based on data from the Midwest Kidney Network, This likely represents a shift in the dialysis delivery systems and not a true increase in absolute new cases.
Among more populated states, annual increases in Iowa and Kansas led the division, while annual counts in Minnesota and Nebraska mostly decreased.
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15. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 5, South Atlantic Patients aged 18 years or older. APC annual percent change. Map shows counts
More incident ESRD patients initiated dialysis in freestanding facilities in the South Atlantic division than in any other division, although the increase in annual counts was modest, with an overall annual percent change of only 1.5.
Division 5 ● South Atlantic
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16. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 6, East South Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities increased in the East South Central division, with an annual percent change of 1.8.
Interestingly, annual counts increased most rapidly in Kentucky and Tennessee, which share a boarder; Kentucky shares its northern border with Indiana and Ohio, the two states in the East North Central division with the most rapid increases in annual counts.
Division 6 ● East South Central
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17. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 4, West North Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 4 ● West North Central
North Dakota, the most rural state in the country, tripled its dialysis population over the past 10 years. The source of this increase should be investigated, but as with the incident patient counts, it could be due to new freestanding facilities opening (based on data from the Midwest Kidney Network,
In the remaining West North Central states, growth was strongest in Iowa (annual percent change 4.5) and slowest in Nebraska (annual percent change 2.7).
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18. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 5, South Atlantic Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 5 ● South Atlantic
Growth in prevalent patient counts varied little across South Atlantic states over 10 years, especially with regard to the larger states.
Growth was strongest in the smallest state, Delaware, (annual percent change 6.2) and slowest in the District of Columbia (annual percent change 2.7).
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19. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 6, East South Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Growth in prevalent patient counts has been steady and consistent in the East South Central division over 10 years, with an overall annual percent change of 4.0.
Division 6 ● East South Central
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20. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 7, West South Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 7 ● West South Central
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities increased in the West South Central division, with an annual percent change of 2.1.
Texas led the division, with an annual percent change of 2.7.
Annual counts of incident patients in Louisiana have been stable since 2005, when Hurricane Katrina struck the Gulf Coast.
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21. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 8, Mountain Patients aged 18 years or older. APC annual percent change. Map shows counts
Annual counts of incident ESRD patients initiating dialysis in freestanding facilities increased in the Mountain division, with an annual percent change of 2.7, the third highest behind the South Atlantic and Pacific divisions.
Idaho, Montana, New Mexico, and Nevada led the division.
Division 8 ● Mountain
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22. Figure 1.a Incidence ESRD patients, by US Census Division and state: Division 9, Pacific Patients aged 18 years or older. APC annual percent change. Map shows counts
More incident ESRD patients initiated dialysis in freestanding facilities in the Pacific division than in any other division except the South Atlantic.
Most incident cases occurred in California, where counts increased by an annual percent change of 2.6.
Annual counts in Hawaii have been relatively stable since 2006, when a large group of dialysis facilities switched from hospital-based to freestanding status (based on data from Health Services Advisory Group Network 17,
Division 9 ● Pacific
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23. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 7, West South Central Patients aged 18 years or older. APC annual percent change. Map shows counts
Division 7 ● West South Central
Growth in prevalent patient counts in the West South Central division was slowest in Louisiana, possibly partially due to displacement of the ESRD population after Hurricane Katrina in 2005, as noted in the description of West South Central incident patient counts.
Texas outpaced other West South Central states with regard to growth in prevalent patient counts and population size, with an annual percent change of 5.3 and 5 to 10 times more patients.
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24. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 8, Mountain Patients aged 18 years or older. APC annual percent change. Map shows counts
The overall annual percent change in the Mountain division, 5.6, was second only to the annual percent change in the Pacific division.
The annual percent change was highest in Nevada, at 8.2.
Division 8 ● Mountain
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25. Figure 1.b Prevalent ESRD patients, by US Census Division and state: Division 9, Pacific Patients aged 18 years or older. APC annual percent change. Map shows counts
Growth in prevalent patient counts in the Pacific division was the highest in the country, with an overall annual percent change of 5.8.
Hawaii saw a fourfold increase in the prevalent population over the past decade.
California led the Pacific division in number of patients, with more than ten times the patient population of other Pacific division states and an annual percent change of 5.5.
Division 9 ● Pacific
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26. Figure 1.8 Hemoglobin at dialysis initiation, patients with pre- dialysis ESA use According to the Medical Evidence Report; patients aged 18 years or older.
95th percentile
75th percentile
10.2
Mean
9.4
25th percentile
5th percentile
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27. Figure 1.9 Hemoglobin at dialysis initiation, patients without pre- dialysis ESA use According to the Medical Evidence Report; patients aged 18 years or older.
95th percentile
75th percentile
10.0
Mean
9.6
25th percentile
5th percentile
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28. Figure 1.10 Incidence counts, by US Census Division Patients aged 18 years or older.
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29. Figure Distribution of vascular access technique, incident hemodialysis patients, overall According to the Medical Evidence Report; patients aged 18 years or older.
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