Survival of endstage renal disease patients: Age-adjusted differences in treatment outcomes

Abstract A previous analysis of the survival of endstage renal disease (ESRD) patients stressed that survival on a second ESRD treatment modality, such as home dialysis or transplantation, must consider survival experience on the first treatment modality, which commonly is center dialysis [1]. That study found differences in survival between center dialysis patients and patients transplanted with kidneys from related donors for patients between 15 and 44 years of age, but not for older patients between 45 and 60 years of age. Furthermore, in comparing the survival of cadaver transplant patients to that of center dialysis patients, the relative risk of death for all ages combined was slightly less than one, yet for each of the three age groups considered the relative risk of death was greater than one [1]. These findings strongly suggested that valid analyses of such differences in outcomes must adjust for the age of patients. This study does so by re-analyzing the data reported by Weller et al [1] with an improved statistical method referred to in the previous report [1] and which has been used by Hutchinson, Thomas, and MacGibbon [2]. It, again, looks at survival on the second treatment modality, home dialysis or transplantation, while evaluating survival experience on the first treatment modality, center dialysis. This new analysis provides additional insights into the effect of age of ESRD patients on treatment differences.