Chronic Kidney DiseaseModifications to Objectives and Subobjectives Progress Toward Healthy People 2010 Targets Progress Toward Elimination of Health Disparities Disparities Table (See below) Objectives and Subobjectives |
Midcourse Review > Table of Contents > Focus Area 4: Chronic Kidney Disease > Objectives and Subobjectives
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Objectives and Subobjectives
Goal: Reduce new cases of chronic kidney disease and its complications, disability, death, and economic costs.
As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:
- Changes in the wording of an objective to more accurately describe what is being measured.
- Changes to reflect a different data source or new science.
- Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
- Deletion of an objective or subobjective that lacked a data source.
- Correction of errors and omissions in Healthy People 2010.
Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.1
When changes were made to an objective, three sections are displayed:
- In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
- In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
- In the Revised Objective section, the objective appears as revised as a result of the midcourse review.
Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.
1See Technical Appendix for more information on baseline and target revisions.
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NO CHANGE IN OBJECTIVE (Data updated and footnoted) |
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| 4-1. |
Reduce
the rate of new cases of end-stage renal disease (ESRD). Target: 2211 new cases per million population. Baseline: 3002 new cases of end-stage renal disease per million population were reported in 1997 (age adjusted to 2000 standard population). Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. 1 Target revised from 217 because of baseline revision after November 2000 publication. 2 Baseline revised from 289 after November 2000 publication. |
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NO CHANGE IN OBJECTIVE (Data updated and footnoted) |
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| 4-2. |
Reduce
deaths from cardiovascular disease in persons with chronic kidney failure. Target: 62.11 deaths per 1,000 patient years at risk. Baseline: 86.42 deaths from cardiovascular disease per 1,000 patient years at risk (in persons with ESRD) occurred in 1997. Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. 1 Target revised from 52 because of baseline revision after November 2000 publication. 2 Baseline revised from 70 after November 2000 publication. |
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NO CHANGE IN OBJECTIVE |
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| 4-3. |
Increase
the proportion of treated chronic kidney failure patients who have received
counseling on nutrition, treatment choices, and cardiovascular care 12 months before the start of renal replacement therapy. Target: 60 percent. Baseline: 45 percent of newly diagnosed patients with treated chronic kidney failure received counseling on nutrition, treatment choices, and cardiovascular care in 1996. Target setting method: 33 percent improvement. (Better than the best will be used when data are available.) Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. |
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NO CHANGE IN OBJECTIVE |
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| 4-4. |
Increase
the proportion of new hemodialysis patients who use arteriovenous fistulas as
the primary mode of vascular access. Target: 50 percent. Baseline: 29 percent of newly diagnosed patients 20 years and older with treated chronic kidney failure on hemodialysis used arteriovenous fistulas as the primary mode of vascular access in 1997. Target setting method: 72 percent improvement (consistent with Dialysis Outcomes Quality Initiative [DOQI] guidelines). (Better than the best will be used when data are available.) Data source: Centers for Medicare & Medicaid Services Clinical Performance Measures (CPM) Project, CMS. |
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NO CHANGE IN OBJECTIVE (Data updated and footnoted) |
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| 4-5. |
Increase
the proportion of dialysis patients registered on the waiting list for
transplantation.
Target: 30.01 percent of dialysis patients. Baseline: 21.92 percent of newly diagnosed treated chronic kidney failure patients under age 70 years were registered on the waiting list in 1998.2 Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. 1 Target revised from 66 because of baseline revision after November 2000 publication. 2 Baseline and baseline year revised from 20 and 1994–96 after November 2000 publication. |
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ORIGINAL OBJECTIVE |
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| 4-6. |
Increase
the proportion of patients with treated chronic kidney failure who receive a
transplant within 3 years of registration on the waiting list. Target: 51 registrants per 1,000 patient years at risk. Baseline: 41 registrants per 1,000 patient years at risk (since placed on dialysis) received a transplant within 3 years in 1995–97. Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. |
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OBJECTIVE WITH REVISIONS |
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| 4-6. |
Increase
the proportion of patients with treated chronic kidney failure who receive a
transplant within 3 years of Target: 30.51 percent Baseline: Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. 1 Target revised from 51 because of baseline revision after November 2000 publication. 2 Baseline and baseline year corrected and revised from 41 and 1995–97 after November 2000 publication. |
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REVISED OBJECTIVE |
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| 4-6. |
Increase
the proportion of patients with treated chronic kidney failure who receive a
transplant within 3 years of end-stage renal disease (ESRD). Target: 30.51 percent. Baseline: 23.12 percent of persons under 70 years of age received a transplant within 3 years of renal failure in 1992–94.2 Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. 1 Target revised from 51 because of baseline revision after November 2000 publication. 2 Baseline and baseline year corrected and revised from 41 and 1995–97 after November 2000 publication. |
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NO CHANGE IN OBJECTIVE (Data updated and footnoted) |
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| 4-7. |
Reduce
kidney failure due to diabetes. Target: 901 diabetic persons with new cases of ESRD per million population. Baseline: 1292 diabetic persons with new cases of ESRD per million population were reported in 1997 (age adjusted to 1999 standard population).2 Target setting method: Better than the best. Data source: U.S. Renal Data System (USRDS), NIH, NIDDK. 1 Target revised from 78 because of baseline revision after November 2000 publication. 2 Baseline and baseline year revised from 113 and 1996 after November 2000 publication. |
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ORIGINAL OBJECTIVE |
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| 4-8. |
(Developmental)
Increase the proportion of persons with type 1 or type 2 diabetes and
proteinuria who receive recommended medical therapy to reduce progression to
chronic renal insufficiency. Potential data source: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS. |
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OBJECTIVE WITH REVISIONS |
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| 4-8. |
Target and baseline:
Target setting method: Better than the best. |
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REVISED OBJECTIVE |
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| 4-8. |
Increase
the proportion of persons with type 1 or type 2 diabetes and chronic kidney
disease who receive recommended medical evaluation and treatment to reduce
progression to chronic renal insufficiency.
Target and baseline:
Target setting method: Better than the best. Data sources: Centers for Medicare & Medicaid Services Standard Analytical Files (SAF), CMS, and U.S. Renal Data System (USRDS), NIH, NIDDK. |
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