Objective: To assess whether, in Brazil, the number of years on dialysis treatment in end-stage renal disease (ESRD) patients, with and without diabetes mellitus, relates to mortality risk.
Methods: Analysis of data from the Ministry of Health of Brazil of 25.952 patients older than 18 years who were on dialytic treatment in April 1997. Death cases that occurred from April 1997 to July 2000 were recorded. Cox models were used to estimate the relative risk (RR) of the association between years on dialysis and mortality risk.
Results: The mortality risk was significantly lower in patients on dialysis between 3 and <10 years as compared with 1 to <2 years (RR between 0.78 and 0.88). With adjustments for age and diabetes the effect of years on dialysis was reduced. In diabetics (n=2.952) the adjusted mortality risk showed a trend to decrease with more years on dialysis.
Conclusions: In Brazil, the mortality risk for ESRD patients decreases with the increasing number of years on dialysis up to approximately 10 years. This finding can be partially explained by the lower mean age and prevalence of diabetes mellitus in patients with more years on dialysis treatment. The effect of years on dialysis on the mortality risk seems to be stronger in patients with diabetes.