End Stage Renal Disease

Call for Intent
December 2019

End Stage Renal Disease

NQF is initiating a consensus development project seeking endorsement of measures for End Stage Renal Disease
If, after reviewing this Call for Intent, your organization believes it has one or more measures that address the scope and objectives of this project as described below and would like NQF to evaluate them for possible endorsement, please submit a call for intent to submit candidate standards by 18 August, 2010 to complete this process.
NQF has recently converted to electronic submission of materials. To submit your intent, log in with your NQF username and password and complete the form for each intended measure submission. If you have not created an NQF account, please follow the instructions on the log-in page.
Over half a million American lives have been altered by a diagnosis of ESRD, a serious condition that is almost always fatal unless treated with dialysis or transplantation. ESRD is the only disease-specific condition that is explicitly guaranteed Medicare coverage, with Medicare costs for the condition reaching $23.9 billion in 2007. In the same year, all-cause mortality rates for ESRD were roughly 6–8 times higher for dialysis patients than for the general population. 1

In 2007, incident rates of ESRD fell 2.1% to 354 per million population (over 527,000 cases) — the first decline in rates since 1995. Racial and ethnic differences persist, with 2007 rates in the African American and Native American populations 3.7 and 1.8 times greater, respectively, than the rate among Caucasians, and the rate in the Hispanic population 1.5 times higher than that of non-Hispanics. 2

In 2008, NQF endorsed 25 measures for ESRD care in the areas of anemia; dialysis adequacy; mineral metabolism; vascular access; influenza immunization; mortality; and patient education, perception of care, and quality of life. These measures were intended to facilitate efforts to improve the quality of care delivered to ESRD patients in all care settings, including dialysis facilities, in-home settings, physician offices, and hospitals.
The current project is limited to consideration of additional quality performance measures for patients with ESRD. However, measures that address chronic kidney disease (CKD) to a limited extent, such as those focused on transitioning to successful renal replacement therapy from stage 4 CKD or measures for which the evidence indicates applicability for both ESRD and CKD will be considered for endorsement.

The current project scope does not encompass comprehensive care for CKD which will be addressed in an upcoming endorsement maintenance cycle project for renal disease. Measure developers with renal measures outside the scope of this project (e.g. chronic kidney disease measures) may notify NQF via the “readiness to submit” form.

Although glycemic control and hypertension management may delay progression of kidney failure or cardiovascular complications, NQF-endorsed standards on those topics should be used for ESRD and CKD unless there is evidence supporting specific differences. Review of NQF-endorsed® standards relating to ESRD and/or CKD for maintenance of endorsement will only be conducted in this project if similar candidate standards are submitted that could potentially replace or expand the endorsed standard (e.g., relevant to pediatric patients in addition to adults). NOTE: All remaining NQF-endorsed® ESRD standards, as well as new renal measures, will be reviewed in an upcoming endorsement maintenance cycle project for renal disease.
The candidate measures will be considered for NQF endorsement as voluntary consensus standards. Agreement around the recommendations will be developed through NQF’s formal Consensus Development Process (CDP). This project will involve the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a steering committee.
This project is supported under a contract provided by the Centers for Medicare & Medicaid Services.
For more information, contact Lauren Richie at (202) 783-1300 or via e-mail at lrichie@qualityforum.org.