Abstract: TH-PO265
Survival Sex Differences among Pediatric and Young Adult Hemodialysis Patients in the Global MONDO Registry
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Ye, Xiaoling, Renal Research Institute, New York, New York, United States
- Alvarez-Elias, Ana Catalina, Renal Research Institute, New York, New York, United States
- Hussein, Rasha Hassan, Renal Research Institute, New York, New York, United States
- Filler, Guido, Western University, London, Ontario, Canada
- Ferris, Maria E., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
Group or Team Name
- MONDO Initiative.
Background
For all age groups, women with ESKD on HD have higher rates of cardiovascular (CV) events compared to men, but their all-cause mortality is reduced. Survival in pediatric and young adult HD patients (pts) from across the globe is understudied.
Methods
In this retrospective cohort study, we included all the ptsaged from 0-40 and treated with HD from the global MONDO database (2000 - 2012). Primary cause of ESKD were identified at dialysis initiation. Kaplan-Meier estimate was used to study the survival of male versus female in all age group and each of the age group (0- ≤12, >12-≤18, >18-≤26, >26-≤33, and >33-40) separately.
Results
Of the 21,450 pts, 8,765 (40.9%) were females. Totally, 398,1.9% were 0-≤12; 13,92 (6.5%) were >12-≤18; 4,657 (21.7%) were >18-≤26; 6,398 (29.8%) were >26-≤33; and 8,623 (40.2%) were >33-40. Etiology by condition included 23.9% glomerular disease, 6.5% congenital and acquired urinary diseases, 32.1% other diagnoses, and 37.5% unknown causes of ESKD. There were no difference of pts with CV comorbidity in male vs. females (13%vs.11%). Pts distribution by region included 26.5% from Asia, 41.3% from Europe, 27.7% from Latin America and 4.5% from the US. The median survival time in both sexes was 32 years. Overall, males had a slightly better survival (p=0.0022). Age-stratified survival analysis revealed that males had a better survival than females (P=0.1099) significantly better survival in the >18≤26 age cohort (P<0.0001); all other stratified age groups showed no difference.
Conclusion
In the global MONDO Registry, of 0–40-year-old HD pts, only young adult males (>18≤26 years) had slightly better survival. Otherwise, there is no sex difference. In contrast to the existing literature for all age groups, we did not observe an inequity of survival in male HD pts<40 years old.