This 22nd US Renal Data System (USRDS) Annual Data Report covers data through 2008 and again includes a volume on chronic kidney disease (CKD) in the United States. Using NHANES (National Health and Nutrition Examination Survey), Medicare, and employer group health plan data, we estimate the relationship between kidney disease markers and mortality risk, examine the likelihood of blood pressure and lipid control by CKD stage, and use International Classification of Diseases, Ninth Revision, Clinical Modification CKD diagnosis codes to report on morbidity, mortality, care, and costs during the transition to end-stage renal disease (ESRD).