INFLUENCE OF CO-MORBIDITY ON MORTALITY AND MORBIDITY IN PATIENTS TREATED WITH HEMODIALYSIS

It has been established that mortality among US end-stage renal diseas e patients is higher than in many other developed countries. The expla nation for this apparent difference in outcome results has caused cons iderable concern. The explanations for this difference are complex and could include differences in case mix as well as indices of severity of illness. To evaluate potential patient-based explanations for these discrepancies, we have evaluated existing reports as well as the avai lable database at the Regional Kidney Disease Program at Hennepin Coun ty Medical Center, with particular emphasis on medical co-morbidity pr esent in US end-stage renal disease patients. These data indicate that increasing age, a greater prevalence of diabetes mellitus patients, a nd a greater proportion of end-stage renal disease patients with compl ex medical co-morbidity contribute to the higher mortality seen in US patients receiving hemodialytic therapies. (C) 1994 by the National Ki dney Foundation, Inc.