Mortality Risk for Women on Chronic Hemodialysis Differs by Age. Issue 1 (3rd June 2014)

• Record Type: Journal Article
• Authors: Sood, Manish M; Rigatto, Claudio; Komenda, Paul; Mojica, Julie; Tangri, Navdeep
• Is Part Of: Canadian journal of kidney health and disease =. Volume 1:Issue 1(2014)
• Publication Date: 2014-06-03
• Subjects: Kidneys -- Diseases -- Periodicals; Nephrology -- Periodicals; Dialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Kidney Diseases -- Periodicals; Nephrology -- Periodicals; Dialysis -- Periodicals; Kidney Transplantation -- Periodicals; Dialysis; Kidneys -- Diseases; Kidneys -- Transplantation; Nephrology; Periodicals; Electronic journals; 616.61005
• DOI: 10.1186/2054-3581-1-10
• Languages: English
• ISSNs: 2054-3581

Abstract

Background: Previous reports have demonstrated similar survival for men and women on hemodialysis, despite women's increased survival in the general population. Objectives: To examine the effect of age on mortality in women undergoing chronic hemodialysis. Design: A retrospective cohort study using an administrative data registry, the Canadian Organ Replacement Registry (CORR) from Jan. 2001 and Dec. 2009. Setting: Canada. Patients: 28, 971 (Women 11, 792 (40.7%), Men 17, 179 (59.3%)) incident chronic hemodialysis patients who survived greater than 90 days on dialysis. Measurements: All-cause mortality. Methods: Cox proportional hazards and competing risks models were employed to determine the independent association between sex, age and likelihood of all-cause mortality with renal transplantation as the competing outcome. Results: During the study period, 6060 (51.4%) of women and 8650 (50.4%) of men initiating dialysis died. Younger women experienced higher mortality (Age < 45: Women 22.5%, Men 18.2%, hazard ratio (HR) 1.31 (1.12–1.52)) whereas elderly women experience lower mortality (Age 75–85: Women 65%, Men 67.3%, HR 0.94 95% CI 0.88–0.99, Age > 85: Women 66%, Men 70.2%, HR 0.83 95% CI 0.71–0.97) compared to men. This relationship persisted after accounting for the competing risk of transplantation. Limitations: The cause of death was unknown. Conclusions: Women's survival on chronic hemodialysis varies by age compared to men with a significantly higher mortality in women younger than 45 years old and lower mortality in woman older than 75 years of age.