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

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ÃÖÇü¿¬(Choi Hyung-Yun) - Seoul National University Graduate School of Public Health Department of Public Health
±è¸íÈñ(Kim Myoung-Hee) - Eulji University College of Health Science Department of Dental Hygiene
±èÇö¿í(Kim Hyun-Wook) - Wonkwang University College of Medicine Department of Internal Medicine
ÀÌÁ¤Ç¥(Lee Jung-Pyo) - Seoul National University Boramae Medical Center Department of Internal Medicine
ÀÌÁ¤È¯(Lee Jeong-Hwan) - Hallym University Hangang Sacred Heart Hospital Department of Internal Medicine
¹ÚÁ¤Å¹(Park Jung-Tak) - Yonsei University College of Medicine Department of Internal Medicine
±è°æÈ£(Kim Kyoung-Hoon) - Korea University Graduate School Department of Public Health
¾ÈÇü½Ä(Ahn Hyeong-Sik) - Korea University College of Medicine Department of Preventive Medicine
ÇÑÈÄÀç(Hann Hoo-Jae) - Ewha Womans University Ewha Medical Research Institute
·ùµ¿¿­(Ryu Dong-Ryeol) - Ewha Womans University School of Medicine Department of Internal Medicine

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.

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Dialysis, Mortality, End-stage renal disease, Korea
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The overall SMR for PD patients was higher than that for HD patients, which is consistent with a previous report. However, the SMR for PD patients was lower than that for HD among patients aged 30?9 years, whereas opposite results were shown in other age groups; The SMR of female patients was higher than that of male patients, regardless of dialysis modality.
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DOI
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ICD 03
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