Historically, much of the work in kidney disease population epidemiology has focused on ESRD, thanks to the unique availability of comprehensive national ESRD registries such as the United States Renal Data System (USRDS) and the Australia and New Zealand Dialysis and Transplant Registry. Since the introduction of dialysis and transplantation into medical care, a continued rise in the number of patients being treated for ESRD has been observed (although there are some indications that incidence rates may be leveling off in the USA [1]).

Over a decade ago, Port [2] enumerated three potential explanatory factors for this observed increase in treated ESRD: a true increase in renal disease prevalence; improved prevention or outcomes from cardiovascular disease and other conditions resulting in more patients surviving to ESRD; and broader acceptance of patients into ESRD therapy. Postulated explanations for a true increase in prevalence of CKD include a greater proliferation of environmental toxins; increased use of nephrotoxic agents, such as analgesic medications; and the growing diabetes mellitus epidemic. Much of the