Measuring Senescence Rates of Patients With End-Stage Renal Disease While Accounting for Population Heterogeneity: An Analysis of Data From the ERA-EDTA Registry

Ann Epidemiol. 2016 Nov;26(11):773-779. doi: 10.1016/j.annepidem.2016.08.010. Epub 2016 Aug 31.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Aging; Dialysis; End-stage renal disease; Frailty; Gompertz model; Kidney transplantation; Mortality rate; Population heterogeneity; Senescence; Senescence rate.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aging / physiology*
  • Cause of Death*
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation / methods
  • Kidney Transplantation / mortality*
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Registries*
  • Renal Dialysis / methods
  • Renal Dialysis / mortality*
  • Risk Assessment
  • Sex Factors
  • Survival Analysis