Abstract: FR-PO0539
Excess Death Due to COVID-19 in Dialysis: Results from the Taiwan Renal Data System, 2021-2022
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Hwang, Shang-Jyh, Kaohsiung Medical University, Kaohsiung, Taiwan
- Lin, Ming-Yen, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Taiwan
- Chen, Kung Chao, Pingtung Hospital, Pingtung, Taiwan
- Hsu, Chih-cheng, National Health Research Institutes Institute of Population Health Sciences, Zhunan Township, Taiwan
- Chang, Jer-Ming, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Taiwan
- Wu, Mei-Yi, Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare, New Taipei, Taiwan
- Wu, Mai-Szu, Taipei Medical University, Taipei, Taiwan
Background
From 2019 to 2022, Taiwan faced unprecedented challenges to population health due to the COVID-19 pandemic. It is unclear how the impacts of the COVID-19 pandemic affect the center's dialysis death. This study aims to quantify the impacts of COVID-19 on additional deaths in patients with end-stage kidney disease who underwent dialysis at centers.
Methods
This study utilized the Taiwan Renal Data System database from 2017 to 2022 to detect deaths per week within each observed year in patients with long-term (≧3 months) prevalent dialysis. The deaths in 2017–2020 were considered non-COVID-19-related to detect excessive deaths due to the 2021–2022 COVID-19 endemic in Taiwan. Additionally, we quantified the impacts of different patient characteristics such as age (0–64, 65–74, 75–84, and ≥85 years), sex (male and female), diabetes mellitus (with and without), and modality (hemodialysis and peritoneal dialysis) to identify the vulnerable population in dialysis.
Results
The average annual mortality rate for the period 2017–2020 was 11.8% ± 0.16%. In contrast, the rates were 12.3% and 14.6% in 2021 and 2022, respectively. It displays a higher death number in each week during the 2021–2022 COVID-19 endemic than the control periods (Figure 1). After developing a model using 2017–2020 data to predict the number of deaths per week, the average excess number of deaths in 2021 and 2022 was 40 patients per week, with a 95% confidence interval of 31–49. The excess number accounts for 9.6% of the 2021 mortality rate and 23.8% of the 2022 mortality rate. Older age, male, comorbidity with DM, and hemodialysis have a higher average excess number of deaths compared to their counterparts.
Conclusion
The study demonstrates that the COVID-19 endemic has a substantial impact on the survival of patients undergoing center dialysis after universal vaccination. The evidence highlights the need for a novel care delivery system to help establish a resilient, equitable, and sustainable care system.