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Chapter 5: Mortality 2014 A NNUAL D ATA R EPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE.

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Presentation on theme: "Chapter 5: Mortality 2014 A NNUAL D ATA R EPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE."— Presentation transcript:

1 Chapter 5: Mortality 2014 A NNUAL D ATA R EPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE

2 2 Data Source: Reference Tables H.2, H.8, H.9, and H.10, and special analyses, USRDS ESRD Database. Adjusted for age, sex, race, and primary diagnosis. Ref: 2011 patients. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis. vol 2 Figure 5.1 Adjusted all-cause mortality rates, overall and by modality Vol 2, ESRD, Ch 5

3 3 Data Source: Reference Tables H.4, H.8, H.9, and H.10, and special analyses, USRDS ESRD Database. Adjusted for age, sex, race, and primary diagnosis. Ref: 2011 patients. Abbreviation: ESRD, end-stage renal disease. vol 2 Figure 5.2 Adjusted all-cause mortality rates, by ESRD vintage (a) Transplant Vol 2, ESRD, Ch 5

4 4 Data Source: Reference Tables H.4, H.8, H.9, and H.10, and special analyses, USRDS ESRD Database. Adjusted for age, sex, race, and primary diagnosis. Ref: 2011 patients. Abbreviation: ESRD, end-stage renal disease. vol 2 Figure 5.2 Adjusted all-cause mortality rates, by ESRD vintage (b) Hemodialysis

5 Vol 2, ESRD, Ch 55 Data Source: Reference Tables H.4, H.8, H.9, and H.10, and special analyses, USRDS ESRD Database. Adjusted for age, sex, race, and primary diagnosis. Ref: 2011 patients. Abbreviation: ESRD, end-stage renal disease. vol 2 Figure 5.2 Adjusted all-cause mortality rates, by ESRD vintage (c) Peritoneal dialysis

6 6 Data Source: Special analyses, USRDS ESRD Database. Adjusted (age, race, sex, ethnicity, and primary diagnosis) all-cause and cause-specific mortality in the first year of hemodialysis. Ref: incident hemodialysis patients, 2011. vol 2 Figure 5.3 Adjusted mortality in the first year of hemodialysis, by year of initiation of dialysis (a) All-cause mortality Vol 2, ESRD, Ch 5

7 7 Data Source: Special analyses, USRDS ESRD Database. Adjusted (age, race, sex, ethnicity, and primary diagnosis) all-cause and cause-specific mortality in the first year of hemodialysis. Ref: incident hemodialysis patients, 2011. vol 2 Figure 5.3 Adjusted mortality in the first year of hemodialysis, by year of initiation of dialysis (b) Cardiovascular mortality Vol 2, ESRD, Ch 5

8 8 Data Source: Special analyses, USRDS ESRD Database. Adjusted (age, race, sex, ethnicity, and primary diagnosis) all-cause and cause-specific mortality in the first year of hemodialysis. Ref: incident hemodialysis patients, 2011. vol 2 Figure 5.3 Adjusted mortality in the first year of hemodialysis, by year of initiation of dialysis (c) Infection mortality Vol 2, ESRD, Ch 5

9 9 Data Source: Special analyses, USRDS ESRD Database. Adjusted (age, race, sex, ethnicity, and primary diagnosis) all-cause and cause-specific mortality in the first year of hemodialysis. Ref: incident hemodialysis patients, 2011. vol 2 Figure 5.3 Adjusted mortality in the first year of hemodialysis, by year of initiation of dialysis (d) Other mortality Vol 2, ESRD, Ch 5

10 10 3 months12 months24 months36 months60 months Dialysis 199991.274.961.050.034.5 200191.275.161.851.236.0 200391.275.162.251.837.1 200591.475.763.053.439.0 200791.776.464.454.940.4 Hemodialysis 199990.974.560.749.834.2 200190.974.661.250.735.6 200390.974.561.651.336.5 200591.175.162.452.738.4 200791.475.863.754.239.8 Peritoneal dialysis 199994.379.663.751.736.4 200195.582.067.255.539.3 200396.284.068.957.643.0 200596.485.872.561.945.9 200796.987.674.964.749.2 Deceased-donor transplant 199994.388.683.978.366.5 200195.089.683.377.865.9 200395.890.184.779.669.2 200595.890.085.380.771.3 200796.892.588.484.173.7 Living donor transplant 199997.394.290.785.576.3 200197.593.889.985.876.2 200398.395.892.288.279.9 200598.395.692.589.181.4 200799.297.695.593.087.0 vol 2 Table 5.1 Adjusted survival probabilities among ESRD patients, by months after initiation of treatment 5.1.a By modality and year of initiation of treatment Vol 2, ESRD, Ch 5 Data Source: Reference Tables I.1-I.36, and special analyses, USRDS ESRD Database. Adjusted survival probabilities, from day one, without the 60 day rule, in the ESRD population. Ref: incident ESRD patients, 2011. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Abbreviation: ESRD, end-stage renal disease.

11 11 3 months12 months24 months36 months60 months 2007 cohort Dialysis91.776.464.454.940.4 Hemodialysis91.475.863.754.239.8 Peritoneal dialysis96.987.674.964.749.2 Deceased-donor transplant96.892.588.484.173.7 Living donor transplant99.297.695.593.087.0 Age 0-1998.495.591.989.787.0 20-4497.791.985.981.073.0 45-6495.485.075.767.353.3 65-7491.074.260.849.933.0 75+84.660.443.431.515.8 Sex Male91.776.964.955.441.3 Female91.976.865.255.941.6 Race White91.075.262.953.338.8 Black/African American93.279.168.059.045.3 Native American95.184.771.661.646.8 Asian94.683.874.966.953.7 Other91.172.155.444.226.1 Primary cause of ESRD Diabetes92.777.664.453.737.2 Hypertension92.077.966.457.443.6 Glomerulonephritis94.383.473.966.353.8 Other88.270.059.652.041.6 vol 2 Table 5.1 Adjusted survival probabilities among ESRD patients, by months after initiation of treatment 5.1.b By modality and age, sex, race, and primary cause of ESRD, for patients initiating ESRD treatment in 2007 Vol 2, ESRD, Ch 5 Data Source: Reference Tables I.1-I.36, and special analyses, USRDS ESRD Database. Adjusted survival probabilities, from day one, without the 60 day rule, in the ESRD population. Ref: incident ESRD patients, 2011. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Abbreviation: ESRD, end-stage renal disease.

12 12 Data Source: Reference Table H.13; special analyses, USRDS ESRDS Database; and Table 7 in National Vital Statistics Reports, Deaths: Final Data for 2010. Expected remaining lifetimes (years) of the general U.S. population and of prevalent dialysis and transplant patients. Prevalent ESRD population, 2012, used as weight to calculate overall combined-age remaining lifetimes. acell values combine ages 75-85 and over. Abbreviation: ESRD, end-stage renal disease. vol 2 Table 5.2 Expected remaining lifetime (years) of the general U.S. population, prevalent dialysis patients and transplant patients, by sex and age Vol 2, ESRD, Ch 5 ESRD patients, 2012 General U.S. population, 2010 DialysisTransplant AgesAllMF MF MF 0-1422.323.221.361.060.162.572.970.575.3 15-1919.920.619.048.747.950.059.557.161.7 20-2417.017.716.144.744.045.954.752.456.9 25-2914.915.514.140.740.041.850.047.852.0 30-3413.413.812.736.836.137.945.243.147.2 35-3912.012.311.532.832.133.940.538.542.4 40-4410.510.610.228.928.230.035.933.937.7 45-498.99.08.725.124.426.231.429.633.2 50-547.6 21.620.922.727.225.428.8 55-596.56.46.518.317.719.323.121.524.5 60-645.55.45.615.414.816.419.117.720.3 65-694.64.54.812.912.413.815.514.216.5 70-743.93.84.110.810.411.512.111.012.9 75-793.33.23.59.18.79.79.18.29.7 80-842.72.62.9 aaa 6.55.86.9 85+2.22.12.4 aaa 3.43.03.5 Overall6.6 18.618.019.522.220.723.4

13 13 Data Source: Special analyses, USRDS ESRD Database and Medicare 5 Percent Sample. Adjusted for sex and race. Medicare data limited to patients with at least one month of Medicare eligibility in 2012. Ref: Medicare patients, 2012. Abbreviation: ESRD, end-stage renal disease. vol 2 Figure 5.4 Adjusted all-cause mortality in the ESRD & general populations, by age, 2012 Vol 2, ESRD, Ch 5

14 14 19961997199819992000200120022003200420052006200720082009201020112012 Unadjusted ESRD337329335338324320315307300296286276264257247241223 Dialysis354347354359344342338332327326317308298291281277258 Transplant978997929391 90838077797275747266 General Medicare Cancer150146142139138132128125121122119117115113111109 Diabetes93 94 9087858277797674 71 72 CHF205209208206208202197196189192191190196183189188191 CVA/TIA156 158154153151145143134137135133 125129127128 AMI149 155 157156152153149 148145155146153 163 Adjusted ESRD350341346345329324318309300294284274263255246240223 Dialysis364356361363346343337330322319310299290284275270252 Transplant133112 106116107108112106991001019493948983 General Medicare Cancer14414114013312912612211811211611310710610510210099 Diabetes878988868280787670726966 63 6264 CHF166170167164160157154153145146144143145137138137143 CVA/TIA130 128124122124117116109111108107106100101100103 AMI131 136138133135133 124126128125131122127125137 Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample. Unadjusted and adjusted (sex and race) mortality rates starting with January 1 point prevalent sample in the ESRD and general populations, age 65 and older (per 1,000 patient years at risk). Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease. vol 2 Table 5.3 Unadjusted & adjusted mortality rates in the ESRD & comorbidity- specific Medicare populations, age 65 & older (per 1,000 patient years), by calendar year Vol 2, ESRD, Ch 5

15 15 Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by age and sex, point prevalent sample on January 1, 2012, adjusted for race. Ref: ESRD patients, 2012. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease. vol 2 Figure 5.5 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (a) Ages 65-69

16 Vol 2, ESRD, Ch 516 vol 2 Figure 5.5 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (b) Ages 70-79 Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by age and sex, point prevalent sample on January 1, 2012, adjusted for race. Ref: ESRD patients, 2012. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.

17 Vol 2, ESRD, Ch 517 vol 2 Figure 5.5 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (c) Age 80+ Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by age and sex, point prevalent sample on January 1, 2012, adjusted for race. Ref: ESRD patients, 2012. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.

18 Vol 2, ESRD, Ch 518 vol 2 Figure 5.6 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (a) White Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by race and sex, point prevalent sample on January 1, 2012, adjusted for age group. ~ Estimates shown are imprecise due to small sample size and may be unstable over time. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.

19 Vol 2, ESRD, Ch 519 vol 2 Figure 5.6 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (b) Black/African American Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by race and sex, point prevalent sample on January 1, 2012, adjusted for age group. ~ Estimates shown are imprecise due to small sample size and may be unstable over time. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.

20 Vol 2, ESRD, Ch 520 vol 2 Figure 5.6 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (c) Native American Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by race and sex, point prevalent sample on January 1, 2012, adjusted for age group. ~ Estimates shown are imprecise due to small sample size and may be unstable over time. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.

21 Vol 2, ESRD, Ch 521 vol 2 Figure 5.6 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (d) Asian Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by race and sex, point prevalent sample on January 1, 2012, adjusted for age group. ~ Estimates shown are imprecise due to small sample size and may be unstable over time. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.

22 Vol 2, ESRD, Ch 522 vol 2 Figure 5.6 Adjusted all-cause mortality in the ESRD, dialysis, transplant, and comorbidity-specific Medicare population, by sex, in 2012 (e) Other Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample, 2012. All-cause mortality in the ESRD and Medicare populations with specific comorbid conditions identified in the preceding year, by race and sex, point prevalent sample on January 1, 2012, adjusted for age group. ~ Estimates shown are imprecise due to small sample size and may be unstable over time. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease.


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