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

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

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Seasonal variations may exist in transitioning to dialysis, kidney transplantation and related outcomes among end-stage renal disease (ESRD) patients. Elucidating these variations may have major clinical and healthcare policy implications for better resource allocation across seasons. Methods Using the United States Renal Data System database from 1 January 2000 to 31 December 2013, we calculated monthly counts of transitioning to dialysis or first transplantation and deaths. Crude monthly transition fraction was defined as the number of new ESRD patients divided by all ESRD patients on the first day of each month. Similar fractions were calculated for all-cause and cause-specific mortality and transplantation. Results The increasing trend of the annual transition to ESRD plateaued during 2009-2012 (n = 126 264), and dropped drastically in 2013 (n = 117 372). Independent of secular trends, monthly transition to ESRD was lowest in July (1.65%) and highest in January (1.97%) of each year. All-cause, cardiovascular and infectious mortalities were lowest in July or August (1.32, 0.58 and 0.15%, respectively) and highest in January (1.56, 0.71 and 0.19%, respectively). Kidney transplantation was highest in June (0.33%), and this peak was mainly attributed to living kidney transplantation in summer months. Transplant failure showed a similar seasonal variation to naïve transition, peaking in January (0.65%) and nadiring in September (0.56%). Conclusions Transitioning to ESRD and adverse events among ESRD people were more frequent in winter and less frequent in summer, whereas kidney transplantation showed the reverse trend. The potential causes and implications of these consistent seasonal variations warrant more investigation.

Original languageEnglish (US)
Pages (from-to)ii99-ii105
JournalNephrology Dialysis Transplantation
Volume32
DOIs
StatePublished - Apr 1 2017

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Kidney Transplantation
Chronic Kidney Failure
Mortality
Dialysis
Transplantation
Resource Allocation
Information Systems
Databases
Delivery of Health Care
Transplants
Kidney

Keywords

  • ESRD
  • Hemodialysis
  • Kidney transplantation
  • Mortality
  • Peritoneal dialysis

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

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 G.; Soohoo, Melissa; Wang, Yaping; Ravel, Vanessa; You, Amy S.; Jing, Jennie; Sim, John J.; Nguyen, Danh V.; Gillen, Daniel L.; Saran, Rajiv; Robinson, Bruce; Kovesdy, Csaba P.

In: Nephrology Dialysis Transplantation, Vol. 32, 01.04.2017, p. ii99-ii105.

Research output: Contribution to journalArticle

Obi, Y, Kalantar-Zadeh, K, Streja, E, Rhee, CM, Reddy, UG, Soohoo, M, Wang, Y, Ravel, V, You, AS, Jing, J, Sim, JJ, Nguyen, DV, Gillen, DL, Saran, R, Robinson, B & Kovesdy, CP 2017, 'Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA', Nephrology Dialysis Transplantation, vol. 32, pp. ii99-ii105. https://doi.org/10.1093/ndt/gfw379
Obi, Yoshitsugu ; Kalantar-Zadeh, Kamyar ; Streja, Elani ; Rhee, Connie M. ; Reddy, Uttam G. ; Soohoo, Melissa ; Wang, Yaping ; Ravel, Vanessa ; You, Amy S. ; Jing, Jennie ; Sim, John J. ; Nguyen, Danh V. ; Gillen, Daniel L. ; Saran, Rajiv ; Robinson, Bruce ; Kovesdy, Csaba P. / Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA. In: Nephrology Dialysis Transplantation. 2017 ; Vol. 32. pp. ii99-ii105.
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abstract = "Background Seasonal variations may exist in transitioning to dialysis, kidney transplantation and related outcomes among end-stage renal disease (ESRD) patients. Elucidating these variations may have major clinical and healthcare policy implications for better resource allocation across seasons. Methods Using the United States Renal Data System database from 1 January 2000 to 31 December 2013, we calculated monthly counts of transitioning to dialysis or first transplantation and deaths. Crude monthly transition fraction was defined as the number of new ESRD patients divided by all ESRD patients on the first day of each month. Similar fractions were calculated for all-cause and cause-specific mortality and transplantation. Results The increasing trend of the annual transition to ESRD plateaued during 2009-2012 (n = 126 264), and dropped drastically in 2013 (n = 117 372). Independent of secular trends, monthly transition to ESRD was lowest in July (1.65{\%}) and highest in January (1.97{\%}) of each year. All-cause, cardiovascular and infectious mortalities were lowest in July or August (1.32, 0.58 and 0.15{\%}, respectively) and highest in January (1.56, 0.71 and 0.19{\%}, respectively). Kidney transplantation was highest in June (0.33{\%}), and this peak was mainly attributed to living kidney transplantation in summer months. Transplant failure showed a similar seasonal variation to na{\"i}ve transition, peaking in January (0.65{\%}) and nadiring in September (0.56{\%}). Conclusions Transitioning to ESRD and adverse events among ESRD people were more frequent in winter and less frequent in summer, whereas kidney transplantation showed the reverse trend. The potential causes and implications of these consistent seasonal variations warrant more investigation.",
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T1 - Seasonal variations in transition, mortality and kidney transplantation among patients with end-stage renal disease in the USA

AU - Obi, Yoshitsugu

AU - Kalantar-Zadeh, Kamyar

AU - Streja, Elani

AU - Rhee, Connie M.

AU - Reddy, Uttam G.

AU - Soohoo, Melissa

AU - Wang, Yaping

AU - Ravel, Vanessa

AU - You, Amy S.

AU - Jing, Jennie

AU - Sim, John J.

AU - Nguyen, Danh V.

AU - Gillen, Daniel L.

AU - Saran, Rajiv

AU - Robinson, Bruce

AU - Kovesdy, Csaba P.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background Seasonal variations may exist in transitioning to dialysis, kidney transplantation and related outcomes among end-stage renal disease (ESRD) patients. Elucidating these variations may have major clinical and healthcare policy implications for better resource allocation across seasons. Methods Using the United States Renal Data System database from 1 January 2000 to 31 December 2013, we calculated monthly counts of transitioning to dialysis or first transplantation and deaths. Crude monthly transition fraction was defined as the number of new ESRD patients divided by all ESRD patients on the first day of each month. Similar fractions were calculated for all-cause and cause-specific mortality and transplantation. Results The increasing trend of the annual transition to ESRD plateaued during 2009-2012 (n = 126 264), and dropped drastically in 2013 (n = 117 372). Independent of secular trends, monthly transition to ESRD was lowest in July (1.65%) and highest in January (1.97%) of each year. All-cause, cardiovascular and infectious mortalities were lowest in July or August (1.32, 0.58 and 0.15%, respectively) and highest in January (1.56, 0.71 and 0.19%, respectively). Kidney transplantation was highest in June (0.33%), and this peak was mainly attributed to living kidney transplantation in summer months. Transplant failure showed a similar seasonal variation to naïve transition, peaking in January (0.65%) and nadiring in September (0.56%). Conclusions Transitioning to ESRD and adverse events among ESRD people were more frequent in winter and less frequent in summer, whereas kidney transplantation showed the reverse trend. The potential causes and implications of these consistent seasonal variations warrant more investigation.

AB - Background Seasonal variations may exist in transitioning to dialysis, kidney transplantation and related outcomes among end-stage renal disease (ESRD) patients. Elucidating these variations may have major clinical and healthcare policy implications for better resource allocation across seasons. Methods Using the United States Renal Data System database from 1 January 2000 to 31 December 2013, we calculated monthly counts of transitioning to dialysis or first transplantation and deaths. Crude monthly transition fraction was defined as the number of new ESRD patients divided by all ESRD patients on the first day of each month. Similar fractions were calculated for all-cause and cause-specific mortality and transplantation. Results The increasing trend of the annual transition to ESRD plateaued during 2009-2012 (n = 126 264), and dropped drastically in 2013 (n = 117 372). Independent of secular trends, monthly transition to ESRD was lowest in July (1.65%) and highest in January (1.97%) of each year. All-cause, cardiovascular and infectious mortalities were lowest in July or August (1.32, 0.58 and 0.15%, respectively) and highest in January (1.56, 0.71 and 0.19%, respectively). Kidney transplantation was highest in June (0.33%), and this peak was mainly attributed to living kidney transplantation in summer months. Transplant failure showed a similar seasonal variation to naïve transition, peaking in January (0.65%) and nadiring in September (0.56%). Conclusions Transitioning to ESRD and adverse events among ESRD people were more frequent in winter and less frequent in summer, whereas kidney transplantation showed the reverse trend. The potential causes and implications of these consistent seasonal variations warrant more investigation.

KW - ESRD

KW - Hemodialysis

KW - Kidney transplantation

KW - Mortality

KW - Peritoneal dialysis

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U2 - 10.1093/ndt/gfw379

DO - 10.1093/ndt/gfw379

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