Abstract: FR-PO396
Sex- and Cause-Specific Mortality among US Adults Receiving Maintenance Dialysis: A National Cohort Study
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
- Harding, Jessica L., Emory University School of Medicine, Atlanta, Georgia, United States
- Abi, Nanzha, Emory University Rollins School of Public Health, Atlanta, Georgia, United States
- Patzer, Rachel E., Indiana University School of Medicine, Indianapolis, Indiana, United States
- Rossi, Ana Paula, Piedmont Transplant Center, Atlanta, Georgia, United States
- Pastan, Stephen O., Emory University School of Medicine, Atlanta, Georgia, United States
Background
We examined sex differences in cause-specific mortality among incident dialysis patients overall and by age and race.
Methods
We identified adults aged ≥18 years initiating dialysis between 2000 and 2020 from the United States Renal Data System (n=2.16 million; 43.3% women). Cause-specific mortality (cardiovascular (CVD), withdrawal, infection, cancer, and all other causes) was defined from the Centers for Medicare and Medicaid Death Notification Form. All individuals were followed from dialysis start date until date of death, 10-years, or end of follow-up (December 31, 2021), whichever occurred first. Multivariable Cox proportional hazards models assessed the association between sex and cause-specific mortality overall and stratified by age and race.
Results
Overall, 67.9% and 70.7% of men and women died with median survival times of 2.69 and 2.72 years, respectively. CVD was the leading cause of death (38.6% women; 40.2% men), followed by withdrawal (11.1% women; 9.6% men) and infections (9.8% women; 8.6% men). Overall, women had a 9% and 4% increased risk for infection, withdrawal, and other-related mortality compared with men, Figure. Conversely, women had a 7% and 10% lower likelihood of CVD and cancer-related mortality, respectively, as compared with men. Younger women (vs. men) aged 18-44 years had higher mortality across all specific causes, while older women (vs. men) aged >75 years had lower risks. Black women (vs. men) had higher mortality across all specific causes, but for all other races, sex differences were similar to the overall population.
Conclusion
Adopting a sex-specific approach that additionally incorporates the intersectionality of age and race is crucial to effectively manage complications and mitigate mortality risk among US dialysis patients.