Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA

Obi, Yoshitsugu; Kalantar-Zadeh, Kamyar; Streja, Elani; Rhee, Connie M.; Reddy, Uttam; Soohoo, Melissa; Wang, Yaping; Ravel, Vanessa; You, Amy S.; Jing, Jennie; Sim, John J.; Nguyen, Danh V.; Gillen, Daniel L.; Saran, Rajiv; Robinson, Bruce M.; Kövesdy, Csaba P.

doi:10.1093/ndt/gfw379

Cited by 23 publications

(30 citation statements)

References 33 publications

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“…Our study has demonstrated that pneumonia infection had a winter peak, whereas septicemia did not have a seasonal variation in HD patients. Although previous studies have shown that the mortality from infection tends to be higher in the winter than in the summer in ESRD patients, these studies did not investigate each cause of infection 7,8 . A study in the general population has shown that respiratory infections had a large winter peak, genitourinary-related sepsis had a small summer peak, and sepsis originating from other sources of infection did not have a seasonal variation 2 .…”

Section: Discussionmentioning

confidence: 98%

“…However, the seasonal variation in the mortality from each disease in patients with end-stage renal disease (ESRD) remains unclear, although some studies have investigated the seasonal variations in all-cause mortality or mortality from cardiovascular disease (CVD), infectious disease, or cancer [7][8][9][10] . In addition, because the mortality rate in patients with ESRD is substantially higher and the distribution of cause of death differs 11 , the results in the general population should not be extrapolated to ESRD. There is also a lack in studies investigating the seasonal variation in the transition to renal replacement therapy (RRT) 7,12,13 . Two Japanese studies have shown that the number of initiation of dialysis was largest in the winter 12,13 .…”

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confidence: 99%

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Seasonal variations in cause-specific mortality and transition to renal replacement therapy among patients with end-stage renal disease

Goto

Hamano

Ogata

et al. 2020

Sci Rep

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Despite some studies showing seasonal variations in mortality and the transition to renal replacement therapy in patients with end-stage renal disease, detailed evidence is still scarce. We investigated seasonal variations in patients with end-stage renal disease using a large Japanese database for dialysis patients. We compared the fractions of all-cause and cause-specific mortality and the transition to renal replacement therapy among seasons and performed a mixed-effects Poisson regression analysis to compare the mortality among seasons after adjustment for some variables. The initiation of hemodialysis was highest in winter and lowest in summer. Seasonality in the initiation of peritoneal dialysis and transition to kidney transplantation differed from hemodialysis. All-cause mortality was highest in the winter and lowest in the summer. Death from coronary artery disease, heart failure, cerebral hemorrhage, and infectious pneumonia had similar seasonality, but death from cerebral infarction, septicemia, or malignant tumor did not have similar seasonality. In conclusion, the initiation of hemodialysis, all-cause mortality, and mortality from coronary heart disease, heart failure, cerebral hemorrhage, and infectious pneumonia were significantly highest in winter and lowest in summer. However, the initiation of peritoneal dialysis, transition to kidney transplantation, or mortality from cerebral infarction, septicemia, or malignant tumor did not have similar seasonal variations.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Seasonal variations in cause-specific mortality and transition to renal replacement therapy among patients with end-stage renal disease

Goto

Hamano

Ogata

et al. 2020

Sci Rep

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“…Seasonal variability of health events and outcomes has long been established in the general population and is increasingly recognized as an important phenomenon in patients with kidney disease, including those receiving dialysis. [15][16][17] The duration and intensity of influenza seasons have been identified as contributors to this seasonal increase in health risks, [6][7][8][19][20][21][22][23] especially among vulnerable populations, such as patients with ESRD, in whom the effectiveness of influenza vaccinations is reduced. [24][25][26][27] However, the contribution of ILI to mortality in the ESRD population has not specifically been quantified.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 ILI is of sufficient public-health importance that the CDC closely monitors its epidemiology. 14 Seasonal variation in mortality in patients receiving hemodialysis was recently described, [15][16][17] but the underlying mechanism for these patterns has not been elucidated. Seasonal variation in mortality in patients with ESRD could be linked to the seasonality of ILI activity, but to our knowledge has never been examined explicitly.…”

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confidence: 99%

Excess Deaths Attributable to Influenza-Like Illness in the ESRD Population

Gilbertson

Rothman

Chertow

et al. 2019

JASN

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Background Morbidity and mortality vary seasonally. Timing and severity of influenza seasons contribute to those patterns, especially among vulnerable populations such as patients with ESRD. However, the extent to which influenza-like illness (ILI), a syndrome comprising a range of potentially serious respiratory tract infections, contributes to mortality in patients with ESRD has not been quantified.Methods We used data from the Centers for Disease Control and Prevention (CDC) Outpatient Influenzalike Illness Surveillance Network and Centers for Medicare and Medicaid Services ESRD death data from 2000 to 2013. After addressing the increasing trend in deaths due to the growing prevalent ESRD population, we calculated quarterly relative mortality compared with average third-quarter (summer) death counts. We used linear regression models to assess the relationship between ILI data and mortality, separately for quarters 4 and 1 for each influenza season, and model parameter estimates to predict seasonal mortality counts and calculate excess ILI-associated deaths.Results An estimated 1% absolute increase in quarterly ILI was associated with a 1.5% increase in relative mortality for quarter 4 and a 2.0% increase for quarter 1. The average number of annual deaths potentially attributable to ILI was substantial, about 1100 deaths per year.Conclusions We found an association between community ILI activity and seasonal variation in all-cause mortality in patients with ESRD, with ILI likely contributing to .1000 deaths annually. Surveillance efforts, such as timely reporting to the CDC of ILI activity within dialysis units during influenza season, may help focus attention on high-risk periods for this vulnerable population.

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“…Seasonal variation in the incidence and cardiovascular disease complications in the general population has been well documented [1]. According to the analysis of data from the United States Renal Data System (USRDS) of all prevalent end-stage kidney disease (ESKD) patients between 2000 and 2013, the transition to ESKD (i.e., initiation of renal replacement therapy) and the incidence of all-cause and cause-specific mortality in patients with ESKD were highest during winter months (particularly January) compared to summer months, suggesting the possibility of season-specific precipitants during winter months contributing to adverse outcomes in both the general population and in patients with ESKD [2]. Similar associations have also been observed in a large cohort of 15 056 in-center hemodialysis patients in the USA, with all-cause mortality highest during winter months [14, 95% confidence intervals (CI) 13-15 deaths per 100 patient-years], with lowest mortality during summer months (12, 95% CI 11-13 deaths per 100 patientyears), which may be related to seasonal variations of clinical parameters that are known to influence mortality such as hypertension, intradialytic weight gain, and hyperkalemia [3].…”

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confidence: 99%

The “cold” hard facts-seasonal variation in outcomes after kidney transplantation

Lim

Wong

2018

Transpl Int

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Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA

Cited by 23 publications

References 33 publications

Seasonal variations in cause-specific mortality and transition to renal replacement therapy among patients with end-stage renal disease

Seasonal variations in cause-specific mortality and transition to renal replacement therapy among patients with end-stage renal disease

Excess Deaths Attributable to Influenza-Like Illness in the ESRD Population

The “cold” hard facts-seasonal variation in outcomes after kidney transplantation

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