National Surveillance of Dialysis‐Associated Diseases in the United States, 1997

The Centers for Disease Control and Prevention (CDC) has been conducting surveillance of hemodialysis-associated hepatitis since the early 1970s (1), when the CDC reported that the incidence of hepatitis B virus (HBV) infection among patients and staff during 1972– 1974 had increased by more than 100% to 6.2% and 5.2%, respectively. These early surveys had only a 50– 65% response rate of centers listed by the National Dialysis Registry. In an effort to obtain a higher response rate, and thus more complete information, the CDC initiated a cooperative program with the Health Care Financing Administration (HCFA) in 1976 that provided for a questionnaire from the CDC to be included in HCFA’s annual facility survey. As a result of this collaboration, the response rate to the CDC questionnaire now exceeds 90%. Since collaboration with the HCFA was begun, the CDC survey has been performed for calendar years 1976, 1980, and 1982 to 1997 (2–12). Questions about other hemodialysis-associated diseases and practices not related to hepatitis have been included over the years, and the questionnaire is continually updated to collect data about hemodialysis practices and hemodialysisassociated diseases of current interest and importance. The objectives of this yearly survey are to determine the frequency with which certain hemodialysis practices, including measures designed to prevent disease, are used; determine the frequency of hemodialysis-associated complications and diseases; and to use this information to suggest further measures to prevent complications and disease in hemodialysis patients and staff.