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Kidney International Supplements (2019) 9, e1-e81 e53 Chapter 6. Prevalence, incidence, and characteristics of dialysis patients e57 Chapter 7. Clinical measurement and treatment among dialysis patients e60 Chapter 8. Vascular access e62 Chapter 9. Cardiovascular diseases and diabetes among dialysis patients e63 Chapter 10. Hospitalization e66 Chapter 11. Medical expenditures for dialysis patients e68 Chapter 12. Kidney transplant waiting list e74 Chapter 13. Discussion e75 References e76 Appendices: Definitions of ICD coding e76 Appendix 1 | Coding of various CKD etiologies e77 Appendix 2 | Coding of CKD stages e78 Appendix 3 | Coding of diabetes mellitus e78 Appendix 4 | Coding of hypertension e78 Appendix 5 | Coding of CVD e80 Appendix 6 | Coding of CVD operations e81 Appendix 7 | Coding of AKI www.kisupplements.org d e t a i l e d c o n t e n t s

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Elevated exposure to arsenic disproportionately affects populations relying on private well water in the United States (US). This includes many American Indian (AI) communities where naturally occurring arsenic is often above 10 µg/L, the current US Environmental Protection Agency safety standard. The Strong Heart Water Study is a randomized controlled trial aiming to reduce arsenic exposure to private well water users in AI communities in North Dakota and South Dakota. In preparation for this intervention, 371 households were included in a community water arsenic testing program to identify households with arsenic ≥10 µg/L by inductively coupled plasma mass spectrometry (ICP-MS). Arsenic ≥10 µg/L was found in 97/371 (26.1%) households; median water arsenic concentration was 6.3 µg/L, ranging from <1-198 µg/L. Silica was identified as a water quality parameter that could impact the efficacy of arsenic removal devices to be installed. A low-range field rapid arsenic testing kit evaluated in a small number of households was found to have low accuracy; therefore, not an option for the screening of affected households in this setting. In a pilot study of the effectiveness of a point-of-use adsorptive media water filtration device for arsenic removal, all devices installed removed arsenic below 1 µg/L at both installation and 9 months post-installation. This study identified a relatively high burden of arsenic in AI study communities as well as an effective water filtration device to reduce arsenic in these communities. The long-term efficacy of a community based arsenic mitigation program in reducing arsenic exposure and preventing arsenic related disease is being tested as part of the Strong Heart Water Study.