Measuring senescence rates of patients with end-stage renal disease while accounting for population heterogeneity: an analysis of data from the ERA-EDTA Registry.
Although a population's senescence rate is classically measured as the increase in mortality rate with age on a logarithmic scale, it may be more accurately measured as the increase on a linear scale. Patients on dialysis, who suffer from accelerated senescence, exhibit a smaller increase in their mortality rate on a logarithmic scale, but a larger increase on a linear scale than patients with a functioning kidney transplant. However, this comparison may be biased by population heterogeneity.



Follow-up data on 323,308 patients on dialysis and 91,679 patients with a functioning kidney transplant were derived from the ERA-EDTA Registry. We measured the increases in their mortality rates using Gompertz frailty models that allow individual variation in this increase.



According to these models, the senescence rate measured as the increase in mortality rate on a logarithmic scale was smaller in patients on dialysis, while the senescence rate measured as the increase on a linear scale was larger in patients on dialysis than patients with a functioning kidney transplant.



Also when accounting for population heterogeneity, a population's senescence rate is more accurately measured as the increase in mortality rate on a linear scale than a logarithmic scale.
Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.j.e.koopman@lumc.nl.
Jacob J E
JJ
Koopman
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Anneke
A
Kramer
Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Diana
D
van Heemst
Norwegian Renal Registry, Department of Transplant Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
Anders
A
Åsberg
University of Lille, EA2694, Santé publique: épidémiologie et qualité des soins, Lille, France; CHU Lille, Geriatric Department, Lille, France.
Jean-Baptiste
JB
Beuscart
Department of Nephrology, Ljubljana University Medical Center, Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Jadranka
J
Buturović-Ponikvar
Department of Nephrology and Dialysis, Brugmann University Hospital, Brussels, Belgium.
Frederic
F
Collart
Renal Epidemiology and Information Network (REIN) Registry, French Biomedical Agency, Saint-Denis-la-Plaine, France.
Cécile G
CG
Couchoud
Finnish Registry for Kidney Diseases, Helsinki, Finland; Department of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.
Patrik
P
Finne
Department of Medicine, Zealand University Hospital, Roskilde, Denmark.
James G
JG
Heaf
Division of Nephrology, Ambroise Paré University Hospital, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Research Centre in Epidemiology and Population Health (CESP), Villejuif, France.
Ziad A
ZA
Massy
Department of Nephrology, Dialysis, and Hypertension, AZ Nikolaas, Sint-Niklaas, Belgium.
Johan M J
JM
De Meester
Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Runolfur
R
Palsson
UK Renal Registry, Southmead Hospital, Bristol, UK.
Retha
R
Steenkamp
The Scottish Renal Registry, Information Services Division Scotland, Glasgow, UK.
Jamie P
JP
Traynor
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Kitty J
KJ
Jager
Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
Hein
H
Putter
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D016030:Kidney Transplantation / Q000379:methods / Q000401:mortality*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D006435:Renal Dialysis / Q000379:methods / Q000401:mortality*; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis
Aging; Dialysis; End-stage renal disease; Frailty; Gompertz model; Kidney transplantation; Mortality rate; Population heterogeneity; Senescence; Senescence rate