Kidney Week

Abstract: FR-PO393

Kidney Failure Etiology and Modality Worldwide: Apollo Dial DB

Session Information

• Hemodialysis Epidemiology and Outcomes
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States

Yue Jiao, PhD

• Wolf, Melanie, Fresenius Medical Care, Bad Homburg, Germany

Melanie Wolf

• Croft, Kaitlyn Renee, Fresenius Medical Care, Bad Homburg, Germany

Kaitlyn Renee Croft, MSc

• Carioni, Paola, Fresenius Medical Care, Crema, Italy

Paola Carioni

• Soni, Mitesh, Fresenius Medical Care, Waltham, Massachusetts, United States

Mitesh Soni

• Winter, Anke, Fresenius Medical Care, Bad Homburg, Germany

Anke Winter, MD

• Neri, Luca, Fresenius Medical Care, Crema, Italy

Luca Neri, MD, PhD

• Chaudhuri, Sheetal, Fresenius Medical Care, Waltham, Massachusetts, United States

Sheetal Chaudhuri, PhD

• Singh, Kanti, Fresenius Medical Care, Waltham, Massachusetts, United States

Kanti Singh

• Nikam, Milind, Fresenius Medical Care, Singapore, Singapore

Milind Nikam, MD, MBBS

• Stuard, Stefano, Fresenius Medical Care, Bad Homburg, Germany

Stefano Stuard, MD, PhD

• Guinsburg, Adrian M., Fresenius Medical Care, Buenos Aires, Argentina

Adrian M. Guinsburg, MD

• Chatoth, Dinesh K., Fresenius Medical Care, Waltham, Massachusetts, United States

Dinesh K. Chatoth, MD, FASN

• Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States

Jeffrey L. Hymes, MD

• Koulechov, Kirill, Fresenius Medical Care, Bad Homburg, Germany

Kirill Koulechov, PhD

• Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States

Len A. Usvyat, PhD

• Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States

John W. Larkin, PhD

• Maddux, Franklin W., Fresenius Medical Care AG, Bad Homburg, Hessen, Germany

Franklin W. Maddux, MD

Background

We used a global database representing kidney care across six continents, Apollo Dial DB, to evaluate modality use by kidney failure etiology.

Methods

Apollo Dial DB captures observation-level data (each treatment, lab, value) from 40 countries in a kidney care network (Fresenius Medical Care, Bad Homburg, DE). Data anonymization was performed in alignment with recommendations from a re-identification risk determination (Privacy Analytics, Ontario, CA). The data has >360 variables (demographics, dialysis, diagnoses, labs, medications, surveys, & outcomes) from 01Jan2018-31Mar2021. Kidney failure etiology considered diabetes, other, or unspecified causes. Modality rates after primary dialysis initiation were assessed by etiology group overall, and by world region. Modality use considered hemodialysis (HD) only, peritoneal dialysis (PD) ever, or transplant.

Results

Of 543,169 adults with kidney failure worldwide, 455,769 (80.6%) had a known etiology (diabetes=39.8%, other causes=40.8%, unspecified=19.4%). Overall, 84.8% used HD, 11.0% used PD, and 4.1% used a transplant after dialysis initiation. Modality use by etiology was consistent worldwide for HD and PD, yet kidney failure due to diabetes was associated with lower transplant rates (Figure 1). Regional differences were observed, with lower PD and transplant rates for kidney failure due to diabetes in some regions. Further, large regional differences in unspecified kidney failure etiology were present.

Conclusion

Kidney failure etiology appears to influence modality use. About 40% of people with kidney failure due to diabetes use HD and PD, yet transplant rates are >50% lower. Regional variations exist and kidney failure due to diabetes is also associated with lower PD rates in select regions. Unspecified kidney failure etiology varied by region and further analyses are needed.

Funding

• Commercial Support – Fresenius Medical Care