CHAPTER 3 DEATHS Stephen McDonald 2012 Annual Report—35th Edition ANZDATA Registry Annual Report 2012

Survival among People who Commenced Figure 3.1 Survival among People who Commenced Dialysis 2002—2011 (Non-Indigenous) % (95% CI) Age at Start Time Point (Number of Years from dialysis start) Proportion Surviving Aust (95 % CI) Proportion Surviving NZ (95 % CI) 0– 24 1 97 (95-98) 96 (90-98)   2 93 (90-96) 94 (86-97) 5 90 (85-93) 78 (56-90) 25—44 97 (96-97) 99 (97-100) 91 (90-92) 94 (90-96) 80 (78-83) 73 (64-80) 45—64 92 (91-92) 91 (89-92) 84 (83-85) 81 (78-83) 60 (58-61) 53 (49-58) 65—74 85 (84-86) 84 (81-87) 72 (71-74) 71 (67-75) 41 (39-42) 34 (29-38) 75—84 80 (79-81) 76 (72-80) 64 (62-65) 55 (50-60) 27 (25-28) 19 (14-24) 85 + 69 (65-73) 65 (46-78) 51 (46-55) 43 (26-59) 17 (13-22) 13 (3-31) ANZDATA Registry Annual Report 2012

(per 100 patient years, 95% CI) Figure 3.2 Death Rates During Renal Replacement Therapy All Patients Included who Received Treatment During 2011 Group Dialysis Mortality Rate (per 100 patient years, 95% CI) Transplant Overall Rate Confidence Intervals Confidence Intervals Per 100 patient years Lower Upper Australia 13.7 13.0 14.4 2.4 2.1 2.7 New Zealand 15.5 14.0 17.2 2.8 3.8 Ages (Years)   < 25 1.9 0.8 4.7 0.4 0.1 1.6 25—44 4.9 3.9 6.1 0.6 1.0 45—64 9.5 8.7 10.4 1.8 2.6 65—84 19.2 18.1 20.4 6.2 5.2 7.5 ≥ 85 35.8 30.8 41.6 48.7 20 ~ Diabetes (at RRT start) Non-diabetic 12.1 11.3 18.9 2.3 2.0 Type 1 16.9 13.1 21.9 1.7 4.5 Type 2 1.5 15.4 17.6 3.4 7.1 Coronary artery disease (at RRT start) No 10.7 10.0 11.4 2.2 Yes 20.1 21.4 3.5 6.8 Indigenous Non-Indigenous (Australia) 14.3 13.5 15.0 Non-Indigenous (New Zealand) 16.8 14.5 19.4 2.9 4.0 Aboriginal /Torres Strait Islanders 13.3 1.1 6.5 Maori (in Australia) 11.1 6.3 19.5 No events Maori (in New Zealand) 14.1 3.3 1.4 8.0 Pacific People (in Australia) 4.8 8.4 0.7 Pacific People (in New Zealand) ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.3 ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.4 ANZDATA Registry Annual Report 2012

Age Groups at start of treatment Figure 3.5 Survival of Dialysis Patients by age Age Groups at start of treatment Median (25th and 75th centiles), years   Australia 0-24 years * 25-44 years 9.26 (5.37-*) 45-64 years 6.26 (3.01-2.65) 65-74 years 4.10 (1.84-7.01) 75-84 years 2.97 (1.30-5.27) 85+ years 2.03 (0.73-3.97) New Zealand 9.64 (7.92-*) 7.28 (4.12-*) 4.97 (2.65-8.05) 3.59 (1.81-5.93) 2.51 (1.07-4.26) 1.69 (0.96-3.58) ANZDATA Registry Annual Report 2012

Survival by Age & Comorbidity amongst older age groups Figure 3.6 Survival by Age & Comorbidity amongst older age groups Median (25th and 75th centiles), years Age Groups Any Vascular Disease Diabetes Australia   New Zealand 65-69 years No 5.32 (2.04 -) 6.01 (2.67-7.68) Yes 3.95 (1.93-8.29) 5.23 (4.20-8.69) 4.30 (2.08-7.04) 2.36 (0.87-4.81) 4.31 (1.41-6.96) 4.03 (1.41-4.27) 70-74 years 5.89 (3.24-8.38) 3.33 (2.27-4.41) 5.59 (2.39- ) 3.92 (3.92-4.39)* 3,46 (0.96-5.81) 2.55 (1.63-4.45) 3.65 (1.80-4.97) 3.33 (1.78-4.88) 75-79 years 5.47 (2.14-8.31) 3.43 (3.43-3.43)* 4.00 (1.85-6.35) 1.42 (0.57-2.43) 3.08 (1.04-5.48) 2.97 (1.49-5.74) 80-84 years 3.41 (2.02-6.41) 2.69 (1.65-3.09) 4.34 (2.70-6.17) 0.67 (0.67-0.67)* 2.28(1.09-4.90) 2.82 (2.82-2.82)* 2.37 (1.29-4.55) 2.82 )2.82-2.82)* 85-89 years 2.25 (0.63-7.79) * 2.39 (0.63-) 2.17 (1.32-3.58) 1.38 (1.38-4.91)* 1.57 (0.37-6.09) ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.7 Australia ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.8 New Zealand ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.9 ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.10 ANZDATA Registry Annual Report 2012

Modality at time of death and age at death –2011 Figure 3.11 Modality at time of death and age at death –2011 Cause of Death Haemodialysis   Peritoneal Dialysis Transplant 0 - 44 45 - 64 65 - 74 ≥75 Australia Cardiovascular 16 117 92 159 2 24 39 32 5 19 7 Withdrawal 15 61 110 229 3 13 18 36 4 Cancer 30 29 6 31 27 8 Infection 40 44 54 20 9 Other 17 56 53 74 12 21 10 New Zealand 45 26 1 11 14 ANZDATA Registry Annual Report 2012

Country at time of death and Modality at death among those Figure 3.12 Country at time of death and Modality at death among those who withdrew from dialysis and died in 2011 Cause of Death AUSTRALIA   NEW ZEALAND HD PD GRAFT Cardiovascular 384 97 42 84 49 9 Withdrawal 415 70 10 66 36 5 Cancer 76 16 6 Infection 144 24 38 35 18 7 Other 200 50 40 39 30 13 ANZDATA Registry Annual Report 2012

Death due to withdrawal-2011 (Modality at time of death) Figure 3.13 Death due to withdrawal-2011 (Modality at time of death) Withdrawal Haemodialysis Peritoneal Dialysis Transplant Total Australia   Psychosocial 177 31 6 214 Patient refused further 2 Suicide 1 Cardiovascular comorbidity 75 13 89 Cerebrovascular comorbidity 36 42 Peripheral vascular comorbidity 24 8 33 Malignancy related withdrawal 82 7 91 Withdrawal due to dialysis 19 4 23 415 70 10 495 New Zealand 11 37 17 9 27 5 3 18 15 66 107 ANZDATA Registry Annual Report 2012

Dialysis patients who withdrew by age at death Figure 3.14 Dialysis patients who withdrew by age at death time from first RRT-2011 Time from first RRT AUSTRALIA   NEW ZEALAND 0 - 44 45 - 64 65 - 74 ≥75 Total 3 13 31 30 77 0  1    8   12 1 7 34 57 4    4   2 10 6 25 45 96 172 5    17   16 38 5 32 42 109 189 2   12   14   19 47 18 131 269 495 2  22   43   40 107 ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.15 ANZDATA Registry Annual Report 2012

ANZDATA Registry Annual Report 2012 Figure 3.16 ANZDATA Registry Annual Report 2012