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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Reduce the proportion of adult dialysis patients who rely on catheters for dialysis — CKD‑08 Data Methodology and Measurement

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  United States Renal Data System (USRDS), NIH/NIDDK

Baseline: 16.7 percent of end-stage kidney patients aged 18 years and over used a catheter as the only mode of vascular access in 2016

Target: 10.0 percent

Numerator
Number of adults aged 18 years and over on hemodialysis who are reported to use a catheter as the only mode of vascular access.
Denominator
Number of adults in the study population aged 18 years and over on hemodialysis.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.20.
1
Target-setting method justification
Trend data were evaluated for this objective but it was not possible to project a target because trend analysis showed no significant or minimal improvement over time. A percentage point improvement was calculated using Cohen's h effect size of 0.2. This method was used because the Healthy People 2030 Workgroup Subject Matter Experts selected an ambitious yet achievable target despite little change over the previous decade.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the in-center hemodialysis CMS Clinical Performance Measures data collection form CMS-820:

Numerator:
What type of access was used on the last hemodialysis session on or between mm/dd/yyyy and mm/dd/yyyy at the patient's primary in-center facility?
  1. AV Fistula
  2. Graft with AV Fistula
  3. Graft without AV Fistula
  4. Catheter
  5. Port Access
  6. Unknown

Methodology notes

Data are from the CMS' Clinical Performance Measures (CPM) project. Included patients are those whose date of dialysis initiation, according to the CPM data, occurs in the same year as the data collection, and access type represents the access used during the last quarter of the year, according to the CPM data. CPM is a CMS project developed to collect information on the quality of care provided to the ESKD dialysis patient. The data originate from surveys completed by the patients' primary care facilities, which have been collected on a yearly basis, resulting in a rich source of detailed information useful in the analysis of health care delivery to the dialysis patient. The measure was added to monitor the recommendation that catheter use as the only access mode be reduced.

History

Comparable HP2020 objective
Retained, which includes core objectives that are continuing from Healthy People 2020 with no change in measurement.
Revision History
Revised. 

In 2024, the original baseline was revised from 16.4 to 16.7 percent due to USRDS rates re-estimation. There is some lag in reporting new cases of ESRD. Therefore, each year's Annual Data Report includes re-estimates of earlier year rates. For more information see the USRDS Annual Data Reports. The target was adjusted from 9.7 to 10.0 percent to reflect the revised baseline using the original target-setting method.

1. Effect size h=0.2 was chosen to correspond with 20% improvement from a baseline of 50%.