Abstract: SA-PO1097
Temporal Patterns in Survival Among Patients with Dialysis-Dependence and a Functioning Kidney Transplant in the United States, 2012-2022
Session Information
- Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Joerg, David J., Renal Research Institute, New York, New York, United States
- Hippen, Benjamin E., Global Medical Office, Fresenius Medical Care, Waltham, Massachusetts, United States
- Fuertinger, Doris H., Renal Research Institute, New York, New York, United States
Background
In the United States, mortality rates in end-stage kidney disease (ESKD) populations declined over the past decade until the onset of the COVID-19 pandemic. This study evaluated age- and time-dependent mortality trends in US renal patients from 2012 to 2022 including pandemic-related disruptions.
Methods
Mortality rates among dialysis and kidney transplant recipients aged 35 years and older were retrieved from the US Renal Data System (USRDS) 2024 Annual Data Report. Mortality trends were modelled by fitting analytical functions to the data, enabling the characterization of age- and time-dependent patterns.
Results
Between 2012 and 2022, mortality rates among adults with ESKD in the United States consistently exhibited an exponential relationship with age (appearing as straight lines on a log plot, Fig. 1A). This pattern reflects a doubling of mortality rate over fixed age intervals (“mortality doubling age”). From 2012 to 2019, overall mortality rates declined, while mortality doubling age remained relatively stable: increasing in dialysis patients by 0.22 years per year (95% CI: 0.15, 0.29) and decreasing in transplant recipients by 0.14 years per year (–0.22, –0.07) (Fig. 1B). Beginning in 2020, mortality doubling ages increased substantially. Although the absolute increase in mortality was greater among older patients, the relative increase was greater in younger individuals (Fig. 1A). Concurrently, 1-year survival probabilities declined across all age groups in 2020 (Fig. 1C). Notably, survival probabilities in 45-year-old dialysis patients and 75-year-old transplant patients were similar in magnitude and relative trends (Fig. 1C). By 2022, these measures demonstrated partial recovery, suggesting a return toward pre-pandemic trends.
Conclusion
Analytical parameterization of public health data reveals temporal and age-related patterns in mortality among adults with ESKD. This approach enables quantification of long-term trends in mortality rates from 2012 to 2022, and reveals the disruption of these trends coinciding with the onset of the COVID-19 pandemic.
Funding
- Commercial Support – Fresenius Medical Care