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2015 ANNUAL DATA REPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE Chapter 6: Mortality.

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Presentation on theme: "2015 ANNUAL DATA REPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE Chapter 6: Mortality."— Presentation transcript:

1 2015 ANNUAL DATA REPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE Chapter 6: Mortality

2 Data Source: Reference Tables H.2_adj, H4_adj, H.8_adj, H.9_adj, and H.10_adj; and special analyses, USRDS ESRD Database. Adjusted for age, sex, race, ethnicity, primary diagnosis and vintage. Ref: period prevalent ESRD patients, 2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis. Figure 6.1a Adjusted all-cause mortality (deaths per 1,000 patient-years) by treatment modality: overall, dialysis, and transplant for period-prevalent patients, 1996-2013 Vol 2, ESRD, Ch 62

3 Data Source: Reference Tables H.2_adj, H4_adj, H.8_adj, H.9_adj, and H.10_adj; and special analyses, USRDS ESRD Database. Adjusted for age, sex, race, ethnicity, primary diagnosis and vintage. Ref: period prevalent ESRD patients, 2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis. Figure 6.1b Adjusted all-cause mortality (deaths per 1,000 patient-years) by treatment modality: hemodialysis and peritoneal dialysis for period-prevalent patients, 1996-2013 Vol 2, ESRD, Ch 63

4 Data Source: Special analyses, USRDS ESRD Database. Adjusted for age, sex, race, and primary diagnosis. Ref: period prevalent ESRD patients, 2011. Abbreviation: ESRD, end-stage renal disease. Figure 6.2a Adjusted all-cause mortality (deaths per 1,000 patient-years) by treatment modality, cohort (year of ESRD onset), and number of years after start of dialysis among incident hemodialysis patients, 1996, 2001, 2006, and 2011 Vol 2, ESRD, Ch 64

5 Data Source: Special analyses, USRDS ESRD Database. Adjusted for age, sex, race, and primary diagnosis. Ref: period prevalent ESRD patients, 2011. Abbreviation: ESRD, end-stage renal disease. Figure 6.2b Adjusted all-cause mortality (deaths per 1,000 patient-years) by treatment modality, cohort (year of ESRD onset), and number of years after start of dialysis among incident peritoneal dialysis patients, 1996, 2001, 2006, and 2011 Vol 2, ESRD, Ch 65

6 Data Source: Special analyses, USRDS ESRD Database. Adjusted (age, race, sex, ethnicity, and primary diagnosis) mortality among 2012 incident ESRD patients during the first year of therapy. Ref: incident ESRD patients, 2011. Abbreviations: ESRD, end-stage renal disease; HD, hemodialysis; PD, peritoneal dialysis. Figure 6.3 Adjusted mortality (deaths per 1000 patient-years) by treatment modality and number of months after treatment initiation among ESRD patients, 2012 Vol 2, ESRD, Ch 66

7 Data Source: Special analyses, USRDS ESRD Database. Adjusted (sex and primary diagnosis) all-cause mortality among 2012 period prevalent patients. Ref: period prevalent ESRD patients, 2011. Abbreviation: ESRD, end-stage renal disease. Table 6.1 Adjusted all-cause mortality (deaths per 1,000 patient-years) by patient age and race among ESRD patients, 2012 Vol 2, ESRD, Ch 67 AgeRaceESRDDialysisTransplant 0-21White12314 Black/African American20354 Other14297 22-44White37629 Black/African American486010 Other24386 45-64White9914330 Black/African American9811429 Other719921 65-74White19724570 Black/African American16718371 Other13717161 75+White359382136 Black/African American275283132 Other239254112

8 Data Source: Special analyses, USRDS ESRD Database. Adjusted (age, race, sex, ethnicity, and primary diagnosis) all-cause mortality among 2012 prevalent patients. Ref: period prevalent ESRD patients, 2011. Abbreviations: CVD, cardiovascular disease; ESRD, end-stage renal disease. Table 6.2 Unadjusted percentages of deaths due to cardiovascular disease (CVD), infection, other specified causes, and with missing data, by modality among ESRD patients, 2012 Vol 2, ESRD, Ch 68 Cause-specific mortality CVDInfection Other cause Missing cause Modality ESRD39%9%26% Dialysis41%9%27%23% Transplant11%6%16%68%

9 Data Source: Reference Tables I.1_adj-I.36_adj. Adjusted survival probabilities, from day one, 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. Table 6.3a Adjusted survival (%) by treatment modality and incident cohort year (year of ESRD onset), for ESRD patients in the 2008 incident cohort (initiating ESRD treatment in 2008) Vol 2, ESRD, Ch 69 3 months12 months24 months36 months60 months Hemodialysis 2000 91.074.460.650.134.5 2002 91.074.661.150.735.9 2004 91.074.861.951.837.3 2006 91.175.463.053.438.8 2008 91.476.364.454.740.2 Peritoneal dialysis 2000 94.780.364.352.837.3 2002 95.882.968.457.041.6 2004 96.184.871.860.845.7 2006 96.986.473.762.447.1 2008 97.488.576.466.450.3 Deceased-donor transplant 2000 94.588.182.777.965.8 2002 95.189.984.479.568.8 2004 96.190.485.579.869.7 2006 96.091.486.982.772.4 2008 96.892.888.784.674.6 Living donor transplant 2000 97.093.288.784.974.8 2002 97.694.290.086.377.6 2004 98.295.392.488.981.8 2006 98.696.393.790.883.5 2008 98.797.194.992.286.9

10 Data Source: Reference Tables I.1_adj-I.36_adj. Adjusted survival probabilities, from day one, 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. Table 6.3b Adjusted survival (%) by age, sex, race, and primary cause of ESRD, for ESRD patients in the 2008 incident cohort (initiating ESRD treatment in 2008) Vol 2, ESRD, Ch 610 2008 cohort3 months12 months24 months36 months60 months Age 0-2198.595.393.291.888.7 22-4497.691.886.481.773.8 45-6495.385.676.468.354.5 65-7491.175.061.850.934.1 75+85.162.245.633.217.1 Sex Male91.877.665.956.442.4 Female92.077.966.557.242.8 Race White91.276.364.254.640.2 Black/African American93.179.769.160.146.1 Native American92.578.665.855.942.4 Asian95.385.175.467.053.9 Other90.171.657.747.234.4 Primary cause of ESRD Diabetes92.978.365.254.337.9 Hypertension92.278.867.758.644.6 Glomerulonephritis94.483.874.666.855.1 Other90.171.657.747.234.4 All patients91.977.766.256.842.6

11 Data Source: Reference Table H.13; special analyses, USRDS ESRDS Database; and National Vital Statistics Report. “Table 7. Life expectancy at selected ages, by race, Hispanic origin, race for non-Hispanic population, and sex: United States, 2012 (2015).” Expected remaining lifetimes (years) of the general U.S. population and of period prevalent dialysis and transplant patients. acell values combine ages 75+. Abbreviation: ESRD, end-stage renal disease. Table 6.4 Expected remaining lifetime (years) by age, sex, and treatment modality of prevalent dialysis patients, prevalent transplant patients, and the general U.S. population (2012), based on USRDS data and the National Vital Statistics Report (2013) Vol 2, ESRD, Ch 611 ESRD patients, 2013 General U.S. population, 2012 DialysisTransplant AgeMaleFemaleMaleFemale MaleFemale 0-1424.122.459.261.2 70.775.4 15-1920.919.346.848.6 59.764.4 20-2418.116.542.544.2 55.059.5 25-2915.814.338.640.2 50.354.6 30-3414.113.034.736.4 45.749.7 35-3912.511.730.832.4 41.045.0 40-4410.810.326.928.6 36.440.3 45-499.18.823.224.8 31.935.6 50-547.7 19.821.3 27.731.1 55-596.56.616.618.1 23.726.8 60-645.55.713.815.2 19.822.6 65-694.54.811.412.7 16.218.5 70-743.84.09.410.4 12.814.7 75-793.23.57.7a8.6a 9.811.3 80-842.62.9 7.18.4 85+2.12.4 4.95.8

12 Data Source: Special analyses, USRDS ESRD Database and Medicare 5 percent sample. Adjusted for race. Medicare data limited to patients with at least one month of Medicare eligibility in 2013. Ref: Medicare patients, 2013. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CMS, Centers for Medicare & Medicaid; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease. Table 6.5 Adjusted mortality (deaths per 1,000 patient-years) by age, sex, treatment modality, and Medicare comorbidity among ESRD patients and people covered by Medicare in 2013, based on USRDS and CMS data, 2013 Vol 2, ESRD, Ch 612 AgeSexDialysisTransplantAll MedicareCancerDiabetesCHFCVA/TIAAMI 65-74Male235682775421077591 Female21460186931995696 75+Male35712691135109232167202 Female32112285139104229156212

13 Data Source: Special analyses, USRDS ESRD Database, and Medicare 5 percent sample. Unadjusted and adjusted (sex and race) mortality rates starting with the January 1 point prevalent sample in the ESRD and general populations, aged 65 and older (per 1,000 patient-years at risk). Ref: period prevalent ESRD patients, 2012. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease. Table 6.6a Adjusted mortality (deaths per 1,000 patient-years) by calendar year, treatment modality, and Medicare comorbidity among ESRD patients and comorbidity-specific Medicare populations aged 65 & older, 1996-2005 Vol 2, ESRD, Ch 613 1996199719981999200020012002200320042005 Modality ESRD338357382390375382380391406335 Dialysis349368392402389399400415437365 Transplant79871108273768111810095 Medicare data comorbidities 151146137140142113122120118107 Cancer8076 827768696661 Diabetes170155154155154141143138132131 CHF1241171161261161051111029796 CVA/TIA157132126148142118128119109106 AMI338357382390375382380391406335

14 Data Source: Special analyses, USRDS ESRD Database, and Medicare 5 percent sample. Unadjusted and adjusted (sex and race) mortality rates starting with the January 1 point prevalent sample in the ESRD and general populations, aged 65 and older (per 1,000 patient-years at risk). Ref: period prevalent ESRD patients, 2012. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CVA/TIA, cerebrovascular accident/transient ischemic attack; ESRD, end-stage renal disease. Table 6.6b Adjusted mortality (deaths per 1,000 patient-years) by calendar year, treatment modality, and Medicare comorbidity among ESRD patients and comorbidity-specific Medicare populations aged 65 & older, 1996, 2006-2013 Vol 2, ESRD, Ch 614 1996…200520062007200820092010201120122013 Decline 1996- 2012 Modality ESRD33833528027126126625726522217448% Dialysis34936531030729831330732828821937% Transplant799582749691 9485729% Medicare data comorbidities 15110711010610710298991009934% Cancer80616058575552 535432% Diabetes17013113013413112812512012813123% CHF1249698959089 84929127% CVA/TIA15710611811311710912111712712520% AMI33833528027126126625726522217448%


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