Measuring senescence rates of patients with end-stage renal disease while accounting for population heterogeneity: an analysis of data from the ERA-EDTA Registry

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• 作者：Jacob J.E. Koopman ; MD ; PhD^a ; ^{j.j.e.koopman@lumc.nl" class="auth_mail" title="E-mail the corresponding author} ; Anneke Kramer ; PhD^b ; Diana van Heemst ; PhD^a ; Anders Å ; sberg ; PhD^c ; Jean-Baptiste Beuscart ; MD ; PhD^d ; ^e ; Jadranka Buturović-Ponikvar ; MD ; PhD^f ; ^g ; Frederic Collart ; MD ; PhD^h ; Cé ; cile G. Couchoud ; MD ; PhDⁱ ; Patrik Finne ; MD ; PhD^j ; ^k ; James G. Heaf ; MD ; DMSc^l ; Ziad A. Massy ; MD^m ; ⁿ ; Johan M.J. De Meester ; MD ; PhD^o ; Runolfur Palsson ; MD^p ; ^q ; Retha Steenkamp ; PhD^r ; Jamie P. Traynor ; MD^s ; Kitty J. Jager ; MD ; PhD^b ; Hein Putter ; PhD^t
• 关键词：Aging ; Dialysis ; End-stage renal disease ; Frailty ; Gompertz model ; Kidney transplantation ; Mortality rate ; Population heterogeneity ; Senescence ; Senescence rate
• 刊名：Annals of Epidemiology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：26
• 期：11
• 页码：773-779
• 全文大小：506 K

文摘

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.