Temporal Trends in Incident Mortality in Dialysis Patients: Focus on Sex and Racial Disparities

American Journal of Nephrology
Silvi ShahCharuhas V Thakar

Abstract

Racial minorities and women constitute substantial portions of the incident and prevalent end-stage renal disease (ESRD) population in the United States. Although ESRD is characterized by high mortality, temporal trends, and race and sex differences in mortality have not been studied. We evaluated 944,650 adult patients who initiated dialysis between January 1, 2005 and December 31, 2014, using the United States Renal Data System, for sex-related and race-related trends in mortality. Logistic regression models adjusted for pre-dialysis health status were used to examine associations among the predictors' sex, race, and year of incident dialysis, and the outcome all-cause mortality at 1-year post ESRD. The mean age was 65 ± 14 years. The 1-year crude mortality rates in incident ESRD patients decreased by 28% from 2004 to 2015. Risk-adjusted 1-year mortality decreased by 3% for each later year of incident ESRD (p < 0.001). In general, from 2005 to 2014, mortality rates decreased across both sexes, and all races. White patients experienced the lowest reduction in adjusted 1-year mortality rates (16%). While women experienced a survival advantage over men in 2005, by 2014 it was reversed to survival advantage for men. Combining all...Continue Reading

Citations

Jun 20, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Silvi ShahCharuhas V Thakar
Apr 16, 2021·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Stephanie M Toth-ManikowskiUNKNOWN Chronic Renal Insufficiency Cohort (CRIC) Study Investigators
Jun 28, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jenny H C ChenWai H Lim

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