Abstract: TH-OR001

Comorbid Disease Trends in Hemodialysis and Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • McGill, Rita L., University of Chicago, Chicago, Illinois, United States
  • Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
  • He, Kevin, University of Michigan, Ann Arbor, Michigan, United States
  • Lacson, Eduardo K., Tufts University School of Medicine, Boston, Massachusetts, United States
  • Miskulin, Dana, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
Background

The US Renal Data System has collected comorbid conditions data on incident hemodialysis (HD) and peritoneal dialysis (PD) patients since 1995. We evaluated the prevalence of several comorbid conditions over 20 years, and compared trends in both groups.

Methods

All first-time HD and PD patients 1996-2015 were included, and analyzed by year of initiation. Diabetes (DM) and cardiovascular disease (CVD) were condensed into single variables, to align data obtained from the 1995 and 2005 Medical Evidence forms. The proportions of co-morbid conditions were evaluated with logistic regression, treating year of initiation as a continuous variable, stratifying by dialysis type, and adjusting for age, sex, and race. Five year prevalence trends were expressed as odds ratios (OR) and 95% confidence intervals, with OR > 1 representing increasing prevalence.

Results

Among 1,864,386 HD and 157,395 PD patients, the mean age increased by 3 years; PD patients were consistently 5-6 years younger than HD patients. CVD decreased in PD but remained flat in HD. In HD patients, hypertension (HTN), DM and lung disease (COPD) increased and peripheral vascular disease (PVD) decreased. PD patients had a smaller increase in DM, and COPD and PVD decreased, but HTN increased. Stroke and cancer did not change significantly over time. Five-year OR’s are shown below.

Conclusion

While HD and PD patients in the United States are both becoming older, and increasingly hypertensive and diabetic, the comorbid disease burdens have been diverging over the past 20 years, resulting in PD patients having less DM, CVD, and COPD than their counterparts receiving HD.

Time trends in Comorbid Diseases over 20 years, for HD and PD Patients

Funding

  • NIDDK Support