This section describes surveillance activities and programs of the Federal government related to chronic kidney disease.
In collaboration with the Johns Hopkins University and the University of Michigan, CDC is working to establish a national surveillance system for chronic kidney disease (CKD). Its purpose is to identify existing local and national sources of CKD data; identify gaps and deficiencies in the existing data sources; and propose creative solutions to fill the gaps and remedy the deficiencies. The project will then examine the need for creating new data sources related to CKD and develop a plan to integrate all data sources into a functional surveillance system. CDC will carry out a feasibility study of the plan for the surveillance system, pilot test of the surveillance system, and deliver a final report to the CDC with recommendations.
CDC is also providing supplementary funding to the National Health and Nutrition Examination Survey for the collection and analysis of a laboratory specimen for creatinine and albumin. In the next survey cycle, the program will be pilot testing the collection of a second urine specimen for albumin analysis. The second specimen will be collected by the study participants in his/her home and mailed to the laboratory for analysis. The National Center for Health Statistics will direct the data collection contractor in establishing and revising protocols for the nephrology component and in preparing training and field manuals.
Desmond Williams, MD, PhD
CKD Initiative Team Lead, CDC Division of Diabetes Translation
CMS maintains a partnership with the National Kidney Foundation and other organizations on issues of interest to ESRD and chronic kidney disease patients, such as information about the availability of low-income subsidy for low-income beneficiaries and caregiver efforts.
Other surveillance efforts include monitoring and on-site support surveys and enforcement procedures. CMS also provides certification for new suppliers and services.
The VA/DoD Clinical Practice Guideline for Diabetes Mellitus recommends monitoring the percentage of diabetics with at least one test for microalbumin or who had evidence of medical attention for existing nephropathy. This is the same metric recommended by the National Diabetes Quality Improvement Alliance. Currently, it is up to each clinic or military treatment facility to monitor this metric. The VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease has several additional recommended metrics that are currently monitored at the local level.
The Organ Procurement and Transplantation Network (OPTN) collects and manages scientific data about organ donation and transplantation. OPTN maintains a secure Web-based computer system, which maintains the nation's organ transplant waiting list and recipient/donor organ characteristics.
The Disease Transmission Advisory Committee (DTAC) is an OPTN committee composed of organ procurement organizations, transplant center coordinators, transplant surgeons, and infectious disease, malignancy, and pathology specialists. DTAC considers issues related to the transmission of disease through organ transplantation. The Committee examines individual potential disease transmission cases reported to the OPTN in an effort to confirm transmissions where possible. It reviews aggregate data on all reported cases to assess the risk of donor disease transmission in organ transplantation in the U.S. with the goal of providing:
DTAC may identify disease-transmission related patient safety issues to be addressed, as appropriate, by the OPTN.
The burden of kidney disease among diabetics has been monitored for several years by the IHS Diabetes Program through a yearly chart audit, and includes measure of kidney function, abnormal protein excretion, and blood pressure control. The IHS Diabetes Care and Outcomes Audit ("the Audit") is a process for assessing diabetes care and health outcomes for American Indians and Alaska Natives with diagnosed diabetes. IHS, Tribal, and Urban Indian health care facilities nationwide voluntarily participate in this process each year by performing a self-audit of medical records for their patients with diabetes. By carefully reviewing the results of individual audits, facilities can identify areas for improvement and implement strategies to work toward the goal of providing all diabetes patients with the highest quality of care, as outlined in the IHS Standards of Care for Patients with Type 2 Diabetes.
Karen L. Sheff, MS
The United States Renal Data System (USRDS) is a national data system that collects, analyzes, and distributes information about CKD and end-stage renal disease (ESRD) in the United States. The USRDS is funded directly by NIDDK in conjunction with the Centers for Medicare & Medicaid Services (CMS). USRDS staff collaborates with members of CMS, the United Network for Organ Sharing (UNOS), and the ESRD networks, sharing datasets and actively working to improve the accuracy of ESRD patient information.
Along with producing the Annual Data Report on End-Stage Renal Disease in the United States, the USRDS also produces the Researcher's Guide, fulfills data requests, provides standard analysis files and specialized datasets to researchers, and presents the results of its research at national conferences and in peer-reviewed journals.
The VA/DoD Clinical Practice Guideline for Diabetes Mellitus recommends monitoring of diabetics for the development of albuminuria. This is the same metric recommended by the National Diabetes Quality Improvement Alliance.
The VA has recently begun collaborating with the VA Office of Quality and Performance (OQP) to examine the implementation of the VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease within the primary care setting. The purpose of this CKD pilot metric project is to assess primary care provider recognition of CKD following the release of the CKD clinical practice guideline.
This information was reviewed by KICC agency representatives. It may not reflect new or future agency activities. For more information, please contact the listed representatives.
Page last updated: June 6, 2012