Morbidity and Mortality in Patients with Chronic Kidney Disease
The report presents data on unadjusted and adjusted all-cause mortality rates for Medicare patients aged 66 and older with and without chronic kidney disease (CKD) in 2013. Tables and figures illustrate mortality rates over time, by CKD status, age, sex, race, and stage of CKD. The findings provide valuable insights into the impact of CKD on patient outcomes and highlight the importance of addressing this chronic condition in older adults.
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2015 ANNUAL DATA REPORT VOLUME 1: CHRONIC KIDNEY DISEASE Chapter 3: Morbidity and Mortality in Patients with CKD
Table 3.1 Unadjusted and adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status, 2013 Unadjusted Adjusted No CKD All CKD No CKD All CKD All Age 45.7 140.9 47.2 117.5 66 69 70 74 75 84 85+ Sex Male Female Race White Black/African American Other 15.5 67.7 15.2 66.5 21.1 76.9 20.9 74.7 44.5 123.2 44.5 121.0 141.7 257.6 142.1 255.1 45.9 144.8 52.6 128.7 45.6 137.5 43.4 110.0 46.5 144.3 47.6 118.8 44.7 128.5 50.0 118.7 34.5 113.8 37.7 95.2 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. Abbreviation: CKD, chronic kidney disease. Vol 1, CKD, Ch 3 2
Figure 3.1 Unadjusted and adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and year, 2001-2013 (a) Unadjusted (b) Adjusted Data source: Medicare 5 percent sample. January 1 of each reported year, point prevalent Medicare patients aged 66 and older. Adj: age/sex/race. Ref: 2012 patients. Abbreviation: CKD, chronic kidney disease. Vol 1, CKD, Ch 3 3
Figure 3.2 Unadjusted and adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 4
Figure 3.3 Adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by age, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 5
Figure 3.4 Adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by sex, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 6
Figure 3.5 Adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by race, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. Abbreviations: Af Am, African American; CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 7
Figure 3.6 Adjusted all-cause mortality rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by cardiovascular disease and diabetes mellitus, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. Abbreviations: CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus. Vol 1, CKD, Ch 3 8
Table 3.2 Unadjusted and adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status, 2013 Unadjusted No CKD 244.3 Adjusted All Age All CKD 655.9 No CKD 247.8 All CKD 626.8 66 69 70 74 75 84 85+ Sex Male Female Race White Black/African American Other 154.8 558.8 154.8 558.4 191.6 568.2 191.5 567.5 273.1 660.5 273.1 658.2 419.6 767.9 423.1 769.9 235.8 643.7 250.2 620.2 250.5 666.7 246.7 636.3 246.0 651.5 248.4 624.8 261.2 734.9 273.0 719.7 196.8 572.4 205.7 544.6 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients, aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. Abbreviations: CKD, chronic kidney disease. Vol 1, CKD, Ch 3 9
Figure 3.7 Unadjusted and adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and year, 2001-2013 (a) Unadjusted (b) Adjusted Data source: Medicare 5 percent sample. January 1 of each reported year point prevalent Medicare patients aged 66 and older. Adj: age/sex/race. Ref: 2013 patients. Abbreviations: CKD, chronic kidney disease. Vol 1, CKD, Ch 3 10
Figure 3.8 Adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and stage, 2011-2013 Data source: Medicare 5 percent sample. January 1 of each reported year, point prevalent Medicare patients aged 66 and older. Adj: age/sex/race. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 11
Figure 3.9 Adjusted rates of hospitalization for cardiovascular disease (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and stage, 2011-2013 Data source: Medicare 5 percent sample. January 1 of each reported year, point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 12
Figure 3.10 Adjusted rates of hospitalization for infection (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and stage, 2011-2013 Data source: Medicare 5 percent sample. January 1 of each reported year, point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 13
Figure 3.11 Adjusted rates of hospitalization for causes other than cardiovascular disease and infection (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by CKD status and stage, 2011-2013 Data source: Medicare 5 percent sample. January 1 of each reported year, point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 14
Figure 3.12 Adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by age, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 15
Figure 3.13 Adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by sex, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 16
Figure 3.14 Adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by race, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: Af Am, African American; CKD, chronic kidney disease; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 17
Figure 3.15 Adjusted all-cause hospitalization rates (per 1,000 patient years at risk) for Medicare patients aged 66 and older, by cardiovascular disease and diabetes mellitus, CKD status, and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older. Adj: age/sex/race; rates by one factor are adjusted for the others. Ref: all patients, 2013. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 18
Table 3.3 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from an all-cause index hospitalization between January 1 and December 1, by CKD status and stage, 2013 Stage Unknown /unspecified No CKD All CKD Stages 1-2 Stage 3 Stages 4-5 All Age 15.8 22.3 21.0 22.2 24.1 22.0 66-69 70-74 75-84 85+ 15.3 24.4 23.9 23.6 25.1 25.2 15.5 23.1 21.5 22.4 24.4 23.9 16.1 22.8 20.7 22.6 25.7 22.4 15.9 20.3 19.9 20.9 21.7 19.1 Sex Male Female Race White Black/African American Other No rehospitalization & died Rehospitalization & died Rehospitalization & lived 16.6 22.8 22.0 22.4 25.3 22.5 15.3 21.8 20.1 22.0 23.3 21.6 15.6 21.9 20.7 21.8 23.5 21.7 17.5 25.3 22.7 25.2 27.8 24.8 17.3 21.5 22.3 21.6 22.2 20.7 4.5 6.2 5.6 5.9 8.0 6.2 1.7 2.7 2.1 2.8 3.3 2.6 14.1 19.6 19.0 19.4 20.9 19.4 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013; unadjusted. See Table A for CKD stage definitions. Abbreviations: CKD, chronic kidney disease. Vol 1, CKD, Ch 3 19
Figure 3.16. Adjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare CKD patients aged 66 and older who were discharged alive from an all-cause index hospitalization between January 1 and December 1, by year, 2001-2013 Data source: Medicare 5 percent sample. January 1 of each reported year, point prevalent Medicare patients aged 66 and older with CKD (defined during the prior year), discharged alive from an all-cause index hospitalization between January 1 and December 1 of the reported year. Adj: age/sex/race. Ref: 2013. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized. Vol 1, CKD, Ch 3 20
Figure 3.17 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from an all-cause index hospitalization between January 1 and December 1, by CKD status and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013, unadjusted. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 21
Figure 3.18 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from a cardiovascular-related index hospitalization between January 1 and December 1, by CKD status and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013; unadjusted. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 22
Figure 3.19 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from an infection-related index hospitalization between January 1 and December 1, by CKD status and stage, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013, unadjusted. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 23
Figure 3.20 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from a non-cardiovascular and non-infection related index hospitalization between January 1 and December 1, by CKD status and stage, 2013 Data Source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013; unadjusted. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized; unk/unspc, CKD stage unidentified. Vol 1, CKD, Ch 3 24
Figure 3.21 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from an all-cause index hospitalization between January 1 and December 1, by age and CKD status, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013; unadjusted. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized. Vol 1, CKD, Ch 3 25
Figure 3.22 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from an all-cause index hospitalization between January 1 and December 1, by sex and CKD status, 2013 Data source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013; unadjusted. Abbreviations: CKD, chronic kidney disease; Rehosp, rehospitalized. Vol 1, CKD, Ch 3 26
Figure 3.23 Unadjusted percentage of patients readmitted to the hospital within 30 days of discharge, among Medicare patients aged 66 and older who were discharged alive from an all-cause index hospitalization between January 1 and December 1, by race and CKD status, 2013 Data Source: Medicare 5 percent sample. January 1, 2013 point prevalent Medicare patients aged 66 and older, discharged alive from an all-cause index hospitalization between January 1, 2013, and December 1, 2013; unadjusted. Abbreviations: Af Am, African American; CKD, chronic kidney disease; Rehosp, rehospitalized. Vol 1, CKD, Ch 3 27
