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. 2014 Jun;33(2):89-94.
doi: 10.1016/j.krcp.2014.04.001. Epub 2014 May 28.

Excess mortality among patients on dialysis: Comparison with the general population in Korea

Hyungyun Choi  1 , Myounghee Kim  2 , Hyunwook Kim  3 , Jung Pyo Lee  4 , Jeonghwan Lee  5 , Jung Tak Park  6 , Kyoung Hoon Kim  7 , Hyeong Sik Ahn  8 , Hoo Jae Hann  9 , Dong-Ryeol Ryu  10
Affiliations

Excess mortality among patients on dialysis: Comparison with the general population in Korea

Hyungyun Choi et al. Kidney Res Clin Pract. 2014 Jun.

Abstract

Background: Although patients with end-stage renal disease (ESRD) experience excess mortality compared with the general population, the standardized mortality ratio (SMR) for Korean patients on dialysis has not yet been investigated. In this study, we evaluated the SMR among all Korean ESRD patients on maintenance dialysis in 2009 and 2010, and compared it according to age categories, sex, and dialysis modality.

Methods: We used data from all patients on maintenance dialysis between January 1, 2009 and December 31, 2010 in Korea using the database of the Korean Health Insurance Review and Assessment Service, and the SMR was determined by calculating of the ratio between the number of actual deaths and expected deaths.

Results: A total of 45,568 patients in 2009 and 48,170 patients in 2010 were included in the analysis. The overall age- and sex-adjusted SMR was 10.3 [95% confidence interval (CI), 10.0-10.6] in 2009 and 10.9 (95% CI, 10.7-11.2) in 2010. The SMR for females was much higher than for males. The SMR gradually decreased with increasing age groups. The overall SMR for maintenance hemodialysis patients was lower than that of peritoneal dialysis patients.

Conclusion: The SMR among Korean ESRD patients is likely to be higher than in other countries. Further evaluation is needed to attempt to improve the outcomes.

Keywords: Dialysis; End-stage renal disease; Korea; Mortality.

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Figures

Figure 1
Figure 1
Differences in the prevalence of dialysis patients according to age categories and sex. The peak prevalence in males was in patients aged 70–79 years, whereas the prevalence among female patients aged 70–79 years was similar to those aged 60–69 years in 2009 and 2010. In addition, the prevalence among patients aged ≥70 years in 2010 was higher than in 2009. PMP, per million population.
Figure 2
Figure 2
Gradual changes in the average standardized mortality ratio (SMR) for the years 2009 and 2010 according to age categories and dialysis modality. The SMR sequentially decreased with increasing age category, and the SMR for males was lower than that for females. In addition, the SMR for peritoneal dialysis (PD) patients was comparable to or higher than that for hemodialysis (HD) patients, except in patients aged between 30 years and 49 years.
See this image and copyright information in PMC

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