Kidney Week

Abstract: FR-PO858

Long-Term Trends in the Co-Morbid Disease Burden of Incident Hemodialysis Patients

Session Information

• Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

• McGill, Rita L., University of Chicago, Chicago, Illinois, United States

Rita L. McGill,

• Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States

Jennifer L. Bragg-Gresham,

• He, Kevin, University of Michigan, Ann Arbor, Michigan, United States

Kevin He,

• Lacson, Eduardo K., Tufts University School of Medicine, Boston, Massachusetts, United States

Eduardo K. Lacson,

• Miskulin, Dana, Tufts University School of Medicine, Boston, Massachusetts, United States

Dana Miskulin,

• Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States

Rajiv Saran,

Background

Since April 1995, dialysis facilities and kidney transplant centers in the United States have been required to report the comorbid conditions of all new kidney failure patients to the US Renal Data System (USRDS). We examined the prevalence of several relevant comorbid diagnoses of all new hemodialysis (HD) patients reported to USRDS from 1996-2015.

Methods

All first-time HD patients initiating treatment between January 1996 and December 2015 were included, and analyzed by year of HD initiation. Diabetes and cardiac diagnoses were condensed into single variables, to align data obtained from the 1995 and 2005 versions of the Medical Evidence form. Five year prevalence trends in the proportions of each co-morbid condition were evaluated with logistic regression, treating year of HD initiation as a continuous variable and adjusting for age, sex, and race. Five year prevalence trends were expressed as odds ratios (OR) and 95% confidence intervals (CI), with OR > 1 representing increasing prevalence.

Results

1,864,386 incident HD patients were assessed. Mean age increased gradually over time from 60.9 to 63.8 years. Time trends revealed linear increases in the prevalence of hypertension (OR=1.34, 95% CI=1.34-1.35) and diabetes (OR=1.16, 95% CI= 1.16-1.17). From 2006 onwards there was decreased prevalence of peripheral vascular disease (OR=0.91, 95% CI=0.91-0.91) and cardiovascular disease (OR=0.92, 95% CI=0.91-0.93) . Prevalences of stroke, cancer, and lung disease showed no clinically significant changes.

Conclusion

The HD population in the United States is becoming older, with more hypertension and diabetes, but the prevalences of cardiovascular and peripheral vascular disease have decreased over the past ten years.

Prevalence of Co-morbid Diagnoses, by Year of HD Initiation

Funding

• NIDDK Support