American Journal of Kidney Diseases
Volume 45, Issue 1 , Pages 127-135 , January 2005

Improvements in dialysis patient mortality are associated with improvements in urea reduction ratio and hematocrit, 1999 to 2002

  • Robert A. Wolfe, PhD

      Affiliations

    • Department of Biostatistics, University of Michigan, Ann Arbor, MI USA.
    • Corresponding Author InformationAddress reprint requests to Robert A. Wolfe, PhD, University of Michigan, KECC, 315 W Huron, Ste 240, Ann Arbor, MI 48103.
    • ,
  • Tempie E. Hulbert-Shearon, MS

      Affiliations

    • Department of Biostatistics, University of Michigan, Ann Arbor, MI USA.
    • ,
  • Valarie B. Ashby, MA

      Affiliations

    • Department of Biostatistics, University of Michigan, Ann Arbor, MI USA.
    • ,
  • Sangeetha Mahadevan, MS

      Affiliations

    • Department of Biostatistics, University of Michigan, Ann Arbor, MI USA.
    • ,
  • Friedrich K. Port, MD

      Affiliations

    • University Renal Research and Education Association, Ann Arbor, MI.

Received 5 March 2004 ,Accepted 21 September 2004.

References 

  1. US Renal Data System . USRDS 1999 Annual Data Report . Bethesda, MD: The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1999;
  2. US Renal Data System . USRDS 2003 Annual Data Report . Bethesda, MD: The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2003;
  3. National Kidney Foundation . K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure . Am J Kidney Dis . 2000;35(suppl 2):S1–S140
  4. Centers for Medicare and Medicaid Services . 2002 Annual Report, End-Stage Renal Disease Clinical Performance Measures Project . Baltimore, MD: Department of Health and Human Services, Centers for Medicare and Medicaid Services, Center for Beneficiary Choices; 2002;
  5. Wolfe RA , Ashby VB , Milford EL , et al.   Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant . N Engl J Med . 1999;341:1725–1730
  6. US Organ Procurement and Transplantation Network and the Scientific Registry for Transplant Recipients: 2002 Annual Report of the US Organ Procurement and Transplantation Network and the Scientific Registry for Transplant Recipients: Transplant Data 1992–2001: Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation, Rockville, MD; United Network for Organ Sharing, Richmond, VA; University Renal Research and Education Association, Ann Arbor, MI, 2002
  7. Wolfe RA , Ashby VB , Daugirdas JT , Agodoa LY , Jones CA , Port FK . Body size, dose of hemodialysis, and mortality . Am J Kidney Dis . 2000;35:80–88
  8. Port FK , Ashby VB , Dhingra RK , Roys E , Wolfe RA . Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients . J Am Soc Nephrol . 2002;13:1061–1066
  9. Collins AJ , Li S , St Peter W , et al.   Death, hospitalization, and economic associations among incident hemodialysis patients with hematocrit values of 36 to 39% . J Am Soc Nephrol . 2001;12:2465–2473
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  11. Paniagua R , Amato D , Vonesh E , et al.   Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis (ADEMEX, a prospective, randomized, controlled trial) . J Am Soc Nephrol . 2002;13:1307–1320
  12. Wolfe RA , Gaylin DS , Port FK , Held PJ , Wood CL . Using USRDS generated mortality tables to compare local ESRD mortality rates to national rates . Kidney Int . 1992;42:991–996
  13. SAS Institute Inc . SAS/STAT User’s Guide, version 8 . In: Cary, NC: SAS Institute Inc; 1999;p. 2598–2599
  14. Andersen PK , Borgun O , Gill RD , Keiding N . Statistical Models Based on Counting Processes . New York, NY: Springer-Verlag; 1993; pp 334, 406–407
  15. Collett D . Modeling Survival Data in Medical Research . In: London, UK: Chapman & Hall; 1994;p. 153; equation 5.6, p 151, equation 5.1
  16. Wolfe RA , Ashby VB , Port FK . 1993 DMMS comorbidity index validated by Medical Evidence Form data . J Am Soc Nephrol . 2000;11:1300A; (abstr)
  17. National Center for Health Statistics . Health, United States, 2002 With Rural and Urban Health Chartbook . In: Hyattsville, MD: Centers for Disease Control and Prevention, Health and Human Services Department; 2002;p. 117–118
  18. Wolfe RA , Ashby VB , Hulbert-Shearon TE , Port FK . New dialysis facility mortality statistics (SMRs) adjust for more patient characteristics . J Am Soc Nephrol . 2001;12:1802A; (abstr)
  19. Wolfe RA , Ashby VB , Port FK , et al.   The association between regional death rates and standardized mortality ratios (SMR) by health service areas (HSA) and race and sex group . J Am Soc Nephrol . 1998;9:230A; (abstr)
  20. Ashby VB , Wolfe RA , Loos ME , Port FK . The effect of comorbidities on facility standardized mortality ratios . J Am Soc Nephrol . 1998;9:197A; (abstr)
  21. Port FK , Wolfe RA , Hulbert-Shearon TE , McCullough KP , Ashby VB , Held PJ . High dialysis dose is associated with lower mortality among females but not among males . Am J Kidney Dis . 2004;43:1014–1023
  22. Ma J , Ebben J , Xia H , Collins A . Hematocrit level and associated mortality in hemodialysis patients . J Am Soc Nephrol . 1999;10:610–619
  23. Centers for Medicare and Medicaid Services . 2002 Annual Report, End-Stage Renal Disease Clinical Performance Measures Project . Baltimore, MD: Department of Health and Human Services, Centers for Medicare and Medicaid Services, Center for Beneficiary Choices; 2003;
  24. Lowrie EG , Teng M , Lacson E , Lew N , Lazarus JM , Owen WF . Association between prevalent care process measures and facility specific mortality rates . Kidney Int . 2001;60:1917–1929
  25. McClellan WM , Soucie JM , Flanders WD . Mortality in end-stage renal disease is associated with facility-to-facility differences in adequacy of hemodialysis . J Am Soc Nephrol . 1998;9:1940–1947
  26. Frankenfield DL , Brier ME , Bedinger MR , et al.   Comparison of urea reduction ratio and hematocrit data reported in different data systems (Results from the Centers for Medicare and Medicaid Services and the Renal Network Inc) . Am J Kidney Dis . 2003;41:433–441
  27. Pisoni RL , Bragg-Gresham JL , Young EW , et al.   Anemia management outcomes from 12 countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS) . Am J Kidney Dis . 2004;44:94–111
  28. Dhingra RK , Young EW , Hulbert-Shearon TE , Leavey SF , Port FK . Type of vascular access and mortality in US hemodialysis patients . Kidney Int . 2001;60:1443–1451

 This study was supported through a grant from the Centers for Medicare and Medicaid Services (CMS contract no. 500-01-0056).

PII: S0272-6386(04)01410-6

doi: 10.1053/j.ajkd.2004.09.023

American Journal of Kidney Diseases
Volume 45, Issue 1 , Pages 127-135 , January 2005

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