title: End-stage renal disease attributed to acute tubular necrosis in the United States, 2001-2010.
abstract: OBJECTIVE
  Though end-stage renal disease (ESRD) is increasingly attributed to acute tubular necrosis (ATN), contemporary trends in the rates of incidence and recovery of renal function are poorly defined. Hence, we set out to describe the clinical epidemiology of ESRD due to ATN between 2001 and 2010.
  
  
  METHODS
  We examined United States Renal Data System data (n = 1,070,490) for 2001 through 2010 to calculate the incidence rates and rates of renal recovery and death for patients with ESRD due to ATN treated with renal replacement therapy (RRT, n = 27,603).
  
  
  RESULTS
  Standardized incidence ratios increased between 2001-2002 and 2009-2010 in the overall population (ratio 2.14), having risen in all demographic subgroups examined. Recovery of renal function was more likely in patients with ATN than in matched controls (cumulative incidence 23% vs. 2% at 12 weeks, 34% vs. 4% at 1 year), as was death (cumulative incidence 38% vs. 27% at 1 year). Hazards ratios for renal recovery increased stepwise with year of RRT inception to 1.34 (95% confidence interval 1.24-1.45) for 2009-2010 (vs. 2001-2002). In contrast, hazards ratios for death declined stepwise to 0.83 (0.79-0.87) in 2009-2010.
  
  
  CONCLUSIONS
  While the incidence of ESRD attributed to ATN has increased, prospects of renal recovery and survival have also increased. Despite substantial mortality risk on RRT, renal recovery is not a rare occurrence.
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minn., USA.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Foley
authors.forename: Donal J
authors.initials: DJ
authors.lastname: Sexton
authors.forename: Scott
authors.initials: S
authors.lastname: Reule
authors.forename: Craig
authors.initials: C
authors.lastname: Solid
authors.forename: Shu-Cheng
authors.initials: SC
authors.lastname: Chen
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Collins
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000150:complications / Q000401:mortality; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology