Mortality rate comparisons of never, previously, and currently transplanted ESRD patients.
Based on analysis of data for 68,683 end-stage renal disease (ESRD) patients per year (on average) prevalent between 1987-89, we report mortality rates for never (NTD) and previously (PTD) transplanted dialysis patients and for patients with a first functioning cadaveric transplant (Tx). Data are for black and white patients between the ages of 20 and 65. Using death rates for all ESRD patients as the standard and adjusting for age, race, and diagnosis, the standardized mortality ratios (SMRs) were 1.24, 1.35, and 0.37 for NTD, PTD, and Tx patients, respectively (significantly different from 1.0, p < 0.001). In a direct comparison between NTD and PTD patients, the mortality rate among PTD patients was typically 91 percent (p < 0.001) of the rate among NTD patients, although the size of the ratio varied by race, being 81 percent (p < 0.001) and 96 percent (ns) for black and white patients, respectively. This indicates that part of the reduction in mortality among transplant patients relative to dialysis patients might be attributable to selection of healthier patients for transplant, since PTD patients have lower death rates than do similar NTD patients; and that the overall selection mechanism varies by race.
D000328:Adult; D000367:Age Factors; D044383:Black People; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D016030:Kidney Transplantation; D008875:Middle Aged; D012086:Reoperation; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D001741:Black or African American