Abstract: SA-PO1054
Trends in Outcomes for Patients Receiving Renal Replacement Therapy in Canada
Session Information
- Hemodialysis and Frequent Dialysis - VI
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Wu, Juliana, Canadian Institute for Health Information, Toronto, Ontario, Canada
- Terner, Michael, Canadian Institute for Health Information, Toronto, Ontario, Canada
- Manno, Michael, Canadian Institute for Health Information, Toronto, Ontario, Canada
- Klarenbach, Scott, University of Alberta, Edmonton, Alberta, Canada
Background
Alternate renal replacement therapy (RRT) modalities offer different survival and quality-of-life outcomes for patients. Recent technological and process advances in dialysis treatments and transplantation offer the opportunity for better survival outcomes for patients. Longitudinal data from the Canadian Organ Replacement Register (CORR) for patients receiving RRT in Canada allows for national-level tracking of patient outcomes over time. We analysed patient data from the CORR to investigate the near-, mid- and longer-term survival outcomes for patients receiving RRTs including hemodialysis (in-centre and home), peritoneal dialysis and kidney transplantation (living and deceased donors).
Methods
The dataset comprised 74,108 patients registered in the CORR between 2003 and 2017 for all provinces excluding Quebec. We calculated graft and patient survival rates at 3 months, 1-, 3-, 5- and 10-years after start of dialysis and after transplantation. We calculated Kaplan–Meier survival rates for 10 years after start of dialysis and after transplantation, and we adjusted rates based on a direct-adjusted Cox model controlling for patient age, sex and primary diagnosis of renal disease.
Results
Crude 5-year patient survival rates was highest in the living-donor transplant group (94.6%), followed by the deceased-donor transplant group (88.3%), PD treatment group (51.3%) and HD treatment group (40.9%). Between 2003 and 2012, crude 5-year survival rates for dialysis patients have increased by 6.6 and 7.0 percentage points for HD and PD patients, respectively. Graft survival rates improved over the 10 years by 0.9 and 4.6 percentage points for those who received a donation from a living or deceased donor, respectively.
Conclusion
Crude survival rates have generally increased over time across all RRT modalities, with similar rank order of survival between modalities as previously reported. Improvements in survival rates may reflect improvements in technology, technique, and patient education and characteristics, and process improvements within dialysis and transplant programs in Canada. CORR national data allow measurement and reporting of this important outcome as a performance measure.