Indicator Metadata

Name	Incidence of End-Stage Kidney Disease (ESKD), by Primary Diagnosis
Short/Other Names	Not applicable
Description	Breakdown by primary diagnosis of all incidence patients (new patients) with end-stage kidney disease who began renal replacement therapy (RRT) (either dialysis or renal transplantation) for the first time in the calendar year
Interpretation	Increasing incidence rates over time have important implications for resources, disease management and the need for kidney donation.
HSP Framework Dimension	Health System Outcomes: Improve health status of Canadians
Areas of Need	Not applicable
Geographic Coverage	All provinces/territories
Reporting Level/Disaggregation	Province/Territory, Breakdown by sex, breakdown by age categories
Indicator Results	http://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=136B85A64C62E179A8283687D1765E50

Identifying Information
Name	Incidence of End-Stage Kidney Disease (ESKD), by Primary Diagnosis
Short/Other Names	Not applicable
Indicator Description and Calculation
Description	Breakdown by primary diagnosis of all incidence patients (new patients) with end-stage kidney disease who began renal replacement therapy (RRT) (either dialysis or renal transplantation) for the first time in the calendar year
Calculation: Description	Counts and rates are based on patients registered during a given calendar year in a Canadian facility. Patients who began RRT for ESKD outside of Canada but are subsequently treated in Canada are included in prevalence counts but not incidence counts.
Calculation: Geographic Assignment	Place of service
Calculation: Type of Measurement	Rate - Per 1,000,000
Calculation: Adjustment Applied	None
Calculation: Method of Adjustment	Direct Standardization Standard Population: Canada 2007
Denominator	Description: Canadian population Inclusions: All Canadians currently residing in Canada Exclusions: Not applicable
Numerator	Description: Patients registered in the Canadian Organ Replacement Register (CORR) who started RRT for ESKD Inclusions: Patients registered in CORR during a given calendar year (January 1–December 31) Patients must have a valid primary diagnosis code. Exclusions: Patients who began RRT for ESKD outside of Canada but are subsequently treated in Canada
Background, Interpretation and Benchmarks
Rationale	Disease etiology can be tracked by viewing changes in the primary diagnosis over time. There are significant costs associated with treating this patient group.
Interpretation	Increasing incidence rates over time have important implications for resources, disease management and the need for kidney donation.
HSP Framework Dimension	Health System Outcomes: Improve health status of Canadians
Areas of Need	Not applicable
Targets/Benchmarks	Not applicable
References	Nesrallah GE, Mustafa RA, Clark WF, et al. Canadian Society of Nephrology 2014 Clinical Practice Guideline for Timing the Initiation of Chronic Dialysis. CMAJ. 2014;186(2):112-117. Available at http://www.cmaj.ca/content/186/2/112 Levin A, Hemmelgarn B, Culleton B, et al. Guidelines for Management of Chronic Kidney Disease. CMAJ. 2008;179(11):1154-1162. Available at http://www.cmaj.ca/content/179/11/1154
Availability of Data Sources and Results
Data Sources	CORR
Available Data Years	Type of Year: Calendar First Available Year: 2004 Last Available Year: 2013
Geographic Coverage	All provinces/territories
Reporting Level/Disaggregation	Province/Territory, Breakdown by sex, breakdown by age categories
Result Updates
Update Frequency	Every year
Indicator Results	Web Tool: Quick Stats URL: http://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=136B85A64C62E179A8283687D1765E50
Updates	Not applicable
Quality Statement
Caveats and Limitations	The indicator is based on voluntary data submitted to CORR from facilities across Canada. Submission of data for patients beginning RRT for ESKD is not mandatory.
Trending Issues	An overview of under-reporting of incident ESKD cases can be found in Data Quality Documentation for Users: Canadian Organ Replacement Register, 2004 to 2013 Data.
Comments	Not applicable