Kim Kyung Won, Bae Yoonjong, Lee Jee Young, Jo Young-Il, Cho AJin
Division of Nephrology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea.
Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul 05545, Republic of Korea.
J Clin Med. 2025 Apr 25;14(9):2987. doi: 10.3390/jcm14092987.
: Assessing recent changes in mortality among patients undergoing hemodialysis (HD) can help both to identify the causes of death most closely associated with these changes and to develop prevention strategies. This study explored trends in all-cause and cause-specific mortality among patients undergoing HD in South Korea using an analysis of national data. We used national death certificate and claims data from 2003 to 2021 provided by the National Health Insurance Service. Age-standardized mortality rates (ASRs) were calculated by standardizing to the 2011 population of patients undergoing HD. Joinpoint regression analysis was performed to calculate the annual percentage change (APC) in mortality. All-cause and cause-specific ASRs and APCs were evaluated for the study period. : The proportion of male and older adult patients increased over time. In particular, the proportion of patients aged ≥ 80 years in the 2018-2021 period was more than 4 times higher than in the 2003-2007 period. From 2003 to 2021, there were a total of 136,302 deaths among patients undergoing HD in South Korea. Cardiovascular causes accounted for 13.6% of deaths, and the majority (86.4%) were attributed to noncardiovascular causes. In 2003, the all-cause ASR was 174.1 per 1000 person-years, which steadily decreased to 114.5 per 1000 person-years in 2021. The ASR from cardiovascular disease remained unchanged from 2003 to 2013 but increased by 3.9% (95% confidence interval: 1.3 to 14.0) per year from 2013 to 2021. In contrast, the ASR from noncardiovascular disease decreased during the study period. Nationally representative data showed a declining trend in the ASR among patients undergoing HD from 2003 to 2021. Noncardiovascular disease mortality decreased during the study period, while cardiovascular disease mortality increased.
评估接受血液透析（HD）患者的近期死亡率变化，有助于识别与这些变化密切相关的死亡原因，并制定预防策略。本研究通过对韩国全国数据的分析，探讨了接受HD治疗的患者全因死亡率和特定原因死亡率的趋势。我们使用了韩国国民健康保险服务提供的2003年至2021年全国死亡证明和理赔数据。年龄标准化死亡率（ASRs）通过对2011年接受HD治疗的患者人群进行标准化计算得出。采用Joinpoint回归分析来计算死亡率的年度百分比变化（APC）。对研究期间的全因和特定原因ASRs及APCs进行了评估。随着时间的推移，男性和老年患者的比例有所增加。特别是，2018 - 2021年期间80岁及以上患者的比例比2003 - 2007年期间高出4倍多。2003年至2021年，韩国接受HD治疗的患者共有136,302例死亡。心血管疾病导致的死亡占13.6%，大多数（86.4%）归因于非心血管疾病。2003年，全因ASR为每1000人年174.1例，到2021年稳步降至每1000人年114.5例。心血管疾病的ASR在2003年至2013年保持不变，但在2013年至2021年期间每年增加3.9%（95%置信区间：1.3至14.0）。相比之下，非心血管疾病的ASR在研究期间有所下降。全国代表性数据显示，2003年至2021年接受HD治疗的患者ASR呈下降趋势。研究期间非心血管疾病死亡率下降，而心血管疾病死亡率上升。
