Mortality rates in end-stage renal disease (ESRD) and dialysis populations are declining but remain much higher than in the general population, according to the 2013 Annual Data Report from the U.S. Renal Data System (USRDS).
The adjusted mortality rate among ESRD patients (per 1,000 patient years at risk) decreased from 351 in 1996 to 241 in 2011, a decline of 31.3%. During that same period, the adjusted mortality rate in the dialysis population dropped from 362 to 266, a decrease of 26.5%.
In 2011, among individuals aged 65 years or older, the adjusted mortality rate was 272.5 and 314.3 per 1,000 patient years at risk in the ESRD and dialysis populations, respectively, compared with 48 in the general population.
The adjusted first-year all-cause mortality rate from day 1 in 2010 was 254.4 per 1,000 patient years at risk, 268.8 for hemodialysis (HD) patients, 121.4 for peritoneal dialysis (PD) patients, and 54.4 for kidney transplant patients (from the date of transplant). From day 90, the rate was 221.5 for HD patients and 126 for PD patients.
According to USRDS data, dialysis patients overall had an expected 6.2 years of remaining life, whereas the general population had an expected 22.5 years of remaining life. Kidney transplant recipients fare better than the dialysis patients, with 17.2 years of expected life remaining. The difference in life expectancy between dialysis patients and their non-ESRD counterparts was larger in certain age groups. For example, in the age group 50-54 years, dialysis patients had an expected 7.1 years of remaining life compared with 27.1 years in the general population.