Annual Crude Mortality Research Articles

Unintentional fall-related mortality in the elderly: comparing patterns in two countries with different demographic structure

ObjectivesFalls are among the major external causes of unintentional injury and injury-related mortality in the elderly. The aim of this study was to compare the patterns of unintentional fall-related mortalities...

Evaluation of annual survival and mortality rates and longevity of bottlenose dolphins (Tursiops truncatus) at the United States Navy Marine Mammal Program from 2004 through 2013.

Objective-To evaluate annual survival and mortality rates and the longevity of a managed population of bottlenose dolphins (Tursiops truncatus). Design-Retrospective cohort study. Animals-103 bottlenose dolphins at the US Navy Marine Mammal Program (MMP). Procedures-Population age structures, annual survival and crude mortality rates, and median age at death for dolphins > 30 days old were determined from 2004 through 2013. Results-During 2004 through 2013, the annual survival rates for MMP dolphins ranged from 0.98 to 1.0, and the annual crude mortality rates ranged from 0% to 5%, with a mean of 2.7%. The median age at death was 30.1 years from 2004 through 2008 and increased to 32 years from 2009 through 2013. The maximum age for a dolphin in the study was 52 years. Conclusions and Clinical Relevance-Results indicated that the annual mortality rates were low and survival rates were high for dolphins in the MMP from 2004 through 2013 and that the median age at death for MMP dolphins during that time was over 10 years greater than that reported in free-ranging dolphins. These findings were likely attributable to the continually improving care and husbandry of managed dolphin populations.

Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-up

Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-up

Incidence and survival of colorectal carcinoma among permanent residents in Yangpu district of Shanghai, from 2002 to 2012

To clarify the incidence and survival of colorectal carcinoma (CRC) patients among permanent residents in Yangpu district of Shanghai, from 2002 to 2012. Data of CRC patients in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city. Temporal trend in the incidence of CRC was analyzed by using Annual Percent Change (APC) model. Kaplan-Meier analysis with Log-rank testing was employed to estimate the survival. Incidence and mortality rates were standardized on age composition of standard population from 2000 nationwide census. A total of 5 881 CRC cases were diagnosed from 2002 to 2012 with crude incidence as 50.60/10(5) and standardized one as 31.21/10(5). The crude incidence rates of colon cancer and rectal cancer were 31.09/10(5) and 18.27/10(5), respectively and the standardized rates were 14.49/10(5) and 8.83/10(5), respectively. The incidence rates of colon cancer were not significantly different between different gender. However, the incidence of rectal cancer in males was significantly higher than in females (P < 0.001). The incidence rates of CRC significantly increased in the age group older than 50 years. However, the standardized incidence rate did not change significantly(APC = 0.39). A total of 3 735 cases died of CRC in this period. The annual crude mortality of CRC was 31.35/10(5) with the standardized rate as 13.72/10(5). The mortality kept increasing significantly in the population older than 60 years. Mortality of rectal cancer was significantly higher in males than in females (P < 0.001). The 5-year survival rates in both colon cancer and rectal cancer patients were 48.88% and 54.16%, respectively. Survivals were significantly higher in those who had received surgical treatments than in those without surgical treatments (colon cancer: 58.10% vs. 37.22%, P < 0.001; rectal cancer:66.18% vs. 39.37%, P < 0.001). Age seemed to have contributed to an increased morbidity and mortality of CRC in Yangpu district of Shanghai. The mortality of CRC appeared higher than the incidence. Surgical treatment could significantly prolong the survival of CRC patients.

Incidence and survival analysis of renal cell carcinoma patients among permanent residents in Yangpu district of Shanghai during 2002-2012

Objective To analyze the incidence and mortality of bladder cancer patients among permanent residents in Yangpu district of Shanghai from January 2002to December 2012.Methods The data of bladder cancer patients among the permanent residents of Yangpu district were obtained from the database of cancer registration and management system in Shanghai.The temporal trend in the incidence and mortality of bladder cancer was assessed using annual percent change(APC) model.Kaplan-Meier analysis with log-rank test was performed for survival analysis.The incidence and mortality were standardized with age composition of standard population from a nationwide census carried out in 2000.Results A total of 1 252cases with bladder cancer were newly diagnosed between 2002and 2012in Yangpu district,and it accounted for 2.69%ofthe total patients with malignant diseases.The annual crude incidence of bladder cancer was 10.51/105,with that of males being significantly higher than that of females(15.59/105 vs 5.18/105,P0.01).The standardized incidence was 4.83/105, with that of males being also significantly higher than that of females(7.26/105 vs 2.32/105,P0.01).The crude incidence of bladder cancer showed a significant increase(APC=4.14,P0.01)from 2002to 2012;however,the standardized incidence showed no significant increase.The incidence increased rapidly after 50years old.A total of 690cases died of bladder cancer during the study period.The annual crude mortality of bladder cancer was 8.61/105 in males,which was significantly higher than that in females(2.84/105,P0.01).The standardized martality was 3.64/105 in males and 1.15/105 in females(P 0.01).The crude mortality of bladder cancer were increased significantly and the standardized one did not alter significantly during this period.The 5-year survival rate of the newly diagnosed bladder cancer patients was 63.15%,with that of surgically treated ones being significantly higher that of non-surgically treated ones(74.31% vs 51.80%,P0.01). Conclusion The crude incidence and mortality of bladder cancer are greatly increased during 2002-2012.Surgical treatment can significantly prolong the survival of bladder cancer patients.Early diagnosis and prompt surgical resection can improve the overall survival of bladder cancer patients.

Suicide Mortality After Spinal Cord Injury in the United States: Injury Cohorts Analysis

ObjectivesTo compare 12-year suicide-specific mortalities of 3 different injury cohorts, identify the risk factors for suicide mortality after spinal cord injury (SCI), and investigate whether suicide mortality is higher among those with SCI than in the general population. DesignRetrospective cohort study. SettingUnited States hospitals (n=28) designated as SCI Model Systems. ParticipantsParticipants (N=31,339) injured between January 1, 1973, and December 31, 1999. InterventionsNot applicable. Main Outcome MeasureSuicide death after SCI. ResultsThe crude annual suicide mortality rate during the first 12 years after SCI was 91 per 100,000 person-years for 1973 to 1979 injury cohort, 69 per 100,000 person-years for 1980 to 1989 injury cohort, and 46 per 100,000 person-years for 1990 to 1999 injury cohort. Suicide mortality was associated with race, injury severity, and years since injury. The standardized mortality ratios for the 3 cohorts were 5.2, 3.7, and 3.0, respectively. ConclusionsSuicide mortality among those with SCI decreased over 3 injury cohorts, but it still remained 3 times higher than that of the general population.

Inter-municipal commuting and impact of PM10 on mortality in the Lombardy region, Italy

Background. In evaluating the impact of air pollution on human health, the assumption of a static population is usual. However, daily commuting between home and work/school place may influence the impact estimate in the presence of different levels of exposure over the area of interest. Mobility in the Lombardy region is important, with the largest percentage of resident population which moves daily to its job or school place among the Italian regions. Moreover the air pollution levels are heterogeneus, with very high concentrations in the Po river plain. Aims. Our aim was to quantify the short term impact of PM10 exposure on mortality in the Lombardy region during 2007, accounting for inter-municipality school and job commuting. Methods. We used inter-municipality commuting flows from the 2001 census to estimate the yearly number of attributable deaths in each municipality. We assumed that the commuters were exposed to the PM10 levels of the municipality where they work or study for one third of their time. Bayesian geostatistical models were specified to obtain shrunken estimates of PM10 annual levels and crude mortality rates at the municipality level, while we used the estimated effects of PM10 from a meta-analysis involving the 13 largest municipalities of the region. We accounted for all sources of uncertainty through a Monte Carlo simulation approach. Results. In 2007, annual PM10 levels exceeding 20 ?g/m3 were responsible for 711 deaths in the whole region. The capital city, Milan, spreaded its impact in the surrounding areas: 284 deaths were attributable to the air pollution level in Milan, 7% of which among residents in other municipalities. Conclusions. Accounting for commuting provides information on the impact that the air pollution level in each single municipality has on the whole region. This may help to detect areas where air pollution reduction interventions are a priority in order to protect and improve individual and community health.

Risk of Death After Hospital Discharge With Traumatic Spinal Cord Injury: A Population-Based Analysis, 1998–2009

ObjectiveTo investigate risk factors associated with mortality among people with traumatic spinal cord injury (TSCI) after discharge from acute care hospitals in South Carolina and to compare their mortality experiences with the general population. DesignRetrospective cohort study. SettingSixty-two acute care, nonfederal hospitals. ParticipantsPersons (N=2685) with TSCI. InterventionsNot applicable. Main Outcome MeasuresDeath after TSCI from all causes within 4288 days of observation after discharge from acute care facilities. ResultsThe crude annual mortality rate during the period was 33 per 1000 person-years. Number of comorbidities, admission into trauma centers, advancing age, type of insurance, injury level and completeness, and being a man were significantly associated (P<.05) with the risk of death after discharge from acute care facilities. The overall mortality rate of our cohort is 3.6 times (95% confidence interval, 3.3–3.9) higher than the general population. ConclusionsThe causes of postdischarge deaths are multifactorial, and more emphasis should be placed on managing and monitoring chronic diseases throughout the recovery process to improve the survivorship of people with TSCI.

Riluzole and Prognostic Factors in Amyotrophic Lateral Sclerosis Long-term and Short-term Survival: A Population-Based Study of 1149 Cases in Taiwan

BackgroundAmyotrophic lateral sclerosis (ALS) is a rare disease in Taiwan; thus, estimation of ALS mortality is difficult. We evaluated factors associated with ALS survival in Taiwan.MethodsThe study enrolled 1149 Taiwanese with a primary diagnosis of ALS during 1999–2008. Follow-up information was available for all patients; mean (SD) duration of follow-up was 2.91 (2.62) years. Medical interventions, including noninvasive positive pressure ventilation (NIPPV), tracheotomy, gastrostomy, and riluzole, were included in time-dependent survival analysis.ResultsOf the 1149 ALS patients, 438 (38.12%) died during follow-up. Mortality in the first year was 16%, which was 13 times (95% CI 11.1–15.2) the age- and sex-standardized rate of the general population in Taiwan. The average annual crude mortality rate was 13.1% (person-years). Factors significantly associated with increased mortality were male sex, advanced age, rural residence, lower economic status, no tracheotomy, and no riluzole treatment. Significant predictors of long-term versus average survival were younger age at diagnosis, being a dependent or receiving social welfare, and NIPPV support. Significant predictors of short-term versus average survival were older age, being employed, no tracheotomy, and no riluzole use.ConclusionsThe results support the use of riluzole to improve ALS survival. Patients who received riluzole and underwent tracheotomy had the best survival.

Mortality from acquired bullous diseases of skin in Canadian adults 2000–2007

Bullous skin diseases are known to be associated with significant morbidity and mortality. There have been no studies on mortality from severe bullous skin diseases in Canada. We used mortality data from the Statistics Canada website from 2000 to 2007 for three major bullous skin diseases: bullous pemphigoid; pemphigus; and toxic epidermal necrolysis (TEN). Crude and age-standardized mortality rates were calculated and compared with the corresponding US mortality rates. Linear regression was used to assess time trend and effect of gender and age on mortality rates. During the period of eight years, there were 115 deaths attributed to pemphigoid, 84 to pemphigus, and 44 to TEN. The crude annual mortality rate was the highest for pemphigoid (0.045 per 100,000), followed by pemphigus (0.033), and TEN (0.017). None of these conditions demonstrated significant time trends in mortality rates over the eight-year period, although a trend towards decreasing pemphigus mortality was observed (P = 0.07). No gender difference in mortality was observed, but advanced age was associated with mortality in all three conditions. Among bullous skin diseases, pemphigoid is the leading cause of mortality in Canada. This is in contrast to the USA, where TEN is the leading cause of mortality from bullous skin diseases. It is not clear whether differences in healthcare systems explain these findings.

Determinants of survival in patients receiving dialysis in Libya

Maintenance dialysis is associated with reduced survival when compared with the general population. In Libya, information about outcomes on dialysis is scarce. This study, therefore, aimed to provide the first comprehensive analysis of survival in Libyan dialysis patients. This prospective multicenter study included all patients in Libya who had been receiving dialysis for >90 days in June 2009. Sociodemographic and clinical data were collected upon enrollment and survival status after 1 year was determined. Two thousand two hundred seventy-three patients in 38 dialysis centers were followed up for 1 year. The majority were receiving hemodialysis (98.8%). Sixty-seven patients were censored due to renal transplantation, and 46 patients were lost to follow-up. Thus, 2159 patients were followed up for 1 year. Four hundred fifty-eight deaths occurred, (crude annual mortality rate of 21.2%). Of these, 31% were due to ischemic heart disease, 16% cerebrovascular accidents, and 16% due to infection. Annual mortality rate was 0% to 70% in different dialysis centers. Best survival was in age group 25 to 34 years. Binary logistic regression analysis identified age at onset of dialysis, physical dependency, diabetes, and predialysis urea as independent determinants of increased mortality. Patients receiving dialysis in Libya have a crude 1-year mortality rate similar to most developed countries, but the mean age of the dialysis population is much lower, and this outcome is thus relatively poor. As in most countries, cardiovascular disease and infection were the most common causes of death. Variation in mortality rates between different centers suggests that survival could be improved by promoting standardization of best practice.

The gap in injury mortality rates between urban and rural residents of Hubei province, China

BackgroundInjury is a growing public health concern in China. Injury death rates are often higher in rural areas than in urban areas in general. The objective of this study is to compare the injury mortality rates in urban and rural residents in Hubei Province in central China by age, sex and mechanism of injury.MethodsUsing data from the Disease Surveillance Points (DSP) system maintained by the Hubei Province Centers for Disease Control and Prevention (CDC) from 2006 to 2008, injury deaths were classified according to the International Classification of Disease-10th Revision (ICD-10). Crude and age-adjusted annual mortality rates were calculated for rural and urban residents of Hubei Province.ResultsThe crude and age-adjusted injury death rates were significantly higher for rural residents than for urban residents (crude rate ratio 1.9, 95% confidence interval 1.8-2.0; adjusted rate ratio 2.4, 95% confidence interval 2.3-2.4). The age-adjusted injury death rate for males was 81.6/100,000 in rural areas compared with 37.0/100 000 in urban areas; for females, the respective rates were 57.9/100,000 and 22.4/100 000. Death rates for suicide (32.4 per 100 000 vs 3.9 per 100 000), traffic-related injuries (15.8 per 100 000 vs 9.5 per 100 000), drowning (6.9 per 100 000 vs 2.3 per 100 000) and crushing injuries (2.0 per 100 000 vs 0.7 per 100 000) were significantly higher in rural areas. Overall injury death rates were much higher in persons over 65 years, with significantly higher rates in rural residents compared with urban residents for suicide (279.8 per 100 000 vs 10.7 per 100 000), traffic-related injuries, and drownings in this age group. Death rates for falls, poisoning, and suffocation were similar in the two geographic groups.ConclusionsRates of suicide, traffic-related injury deaths and drownings are demonstrably higher in rural compared with urban locations and should be targeted for injury prevention activity. There is a need for injury prevention policies targeted at elderly residents, especially with regard to suicide prevention in rural areas in Central China.

Relatório do censo brasileiro de diálise de 2010

National chronic dialysis data are fundamental for treatment planning. To report data of the annual survey of the Brazilian Society of Nephrology about patients with chronic renal failure who were on dialysis in 1 July, 2010. A national survey based on data from the country's dialysis centers. Data collection was performed by using a questionnaire filled out online by the dialysis centers. 340 (53.3%) centers answered the questionnaire. National data were estimated for the overall dialysis population. In July 2010, the estimated total number of patients on dialysis was 92,091. The estimated prevalence and incidence rates of end-stage chronic kidney disease patients on maintenance dialysis were 483 and 100/million population, respectively. The estimated number of patients starting a dialysis program in 2010 was 18,972. The annual crude mortality rate was 17.9%. Of those on maintenance dialysis, 30.7% were aged 65 years or older, 90.6% were on hemodialysis and 9.4% on peritoneal dialysis, 35,639 (38.7%) were on a kidney transplant waiting list, 28% were diabetics, 34.5% had serum phosphorus levels > 5.5 mg/dL, and 38.5% had hemoglobin levels < 11 g/dL. Vascular access was through a venous catheter in 13.6% of the hemodialysis patients. The number of end-stage kidney disease patients on maintenance dialysis is increasing in Brazil. Data concerning the indicators of the quality of maintenance dialysis improved compared to the prior year, and they highlight the importance of the census to guide chronic dialysis therapy.

Causas y tendencia de la mortalidad en una prisión española (1994-2009)

There are a few mortality researches in prisons. To know this measure can to be important for take decisions of Public Health. The aim of the paper is to describe mortality and its trend in our prison. This is a descriptive and retrospective study of the deaths between 01/01/1994 and 31/12/2009. Two periods of 8 years have been compared through exact test of Fisher in order to detect changes in causes of mortality. First of all, we made an indirect standardization of rates and compare mortality in our institution with other Spanish prisons. Through linear regression model we have settled in trends of mortality rates. Had 59 deaths, 58 in men with a median age 34.9 years old (28.7- 40.4). 64,4% were HIV+ . From 1994 to 2001 the main cause of mortality was VIH infection (48.6%) the second one was cardiovascular event (10.8%), while that between 2002 and 2009 this trend have change, cardiovascular event caused (31.8%) and VIH infection (22.07%) (p=0.026).The annual crude mortality rate decreased -0.485 deaths ‰ inmates/year (IC 95%: -0.864 to -0.107). Standardizing rates, we get 42 deaths expected for the wholly period, with Standarized Mortality Ratio of 1.407 (I.C. 95%: 1.071 to 1.816). The main cause of mortality has been no-HIV diseases, among these mainly cardiovascular events. The trend of mortality rate has been decreasing although we observe 40.7% plus of deaths than we would expect.

Temporal trends and geographic clusters of mortality from amyotrophic lateral sclerosis in Japan, 1995–2004

The present study examined temporal trends and geographic clustering of amyotrophic lateral sclerosis (ALS) mortality in Japan, during 1995–2004, using vital statistics based on death certificates. ALS was usually diagnosed by neurologists according to clinical guidelines that complied with the El Escorial Criteria. The underlying cause of death for ALS was coded as G12.2A. Regression analysis was used to examine temporal trends. Spatial scan statistic was used to detect any area of elevated risk as a cluster. A total of 12,173 (6864 male and 5309 female) ALS deaths were reported. Annual crude mortality rate per 100,000 population was 1.07 (1.26 for males and 0.89 for females) in 2004. Although the overall temporal trend was stable, the trend increased in the 70+ years age group ( p for trend, < 0.001 in males and < 0.05 in females), while it declined in the under 70 years age group ( p for trend, < 0.01 for both sexes). Male preponderance and M/F ratio remained nearly constant over time. Three clusters were detected: two ( p < 0.005 in males and p < 0.05 in females) in northeast and one ( p < 0.05 in males) in west-central Japan. Further research is needed to clarify contributing factors for the observed trends and clusters in ALS mortality.

Oral and pharyngeal cancer mortality rates in Mexico, 1979–2003

In Mexico, information on oral and pharyngeal cancer (OPC) is scarce. The purpose of this study was to explore the trends in OPC mortality rates in Mexico from 1979 through 2003 and to describe the distribution of OPC deaths for selected socio-demographic variables for the period of 2001-2003. Annual crude and age-adjusted mortality rates were obtained by gender and site of lesion, using the 2003 WHO World standard million population. The Poisson regression model was used to detect a trend in the mortality rates, testing the hypothesis beta(1) = 0. Also, the annual percentage change (APC) was computed over the age-adjusted rates. The total number of OPC deaths during the period 1979-2003 was 15,576. The age-adjusted mortality rate was 1.13/100,000 in 1979 and 1.08/100,000 in 2003. Oral cancer was more frequently found than salivary gland and pharyngeal cancer (41.5% vs. 13.4% and 17.1%). The tongue (19%) was the most frequent oral affected site. The Poisson regression analysis indicated a stationary trend in cancer mortality rate; also, the APC regression model showed no increase or decrease in OPC from 1979 to 2003. Oral and pharyngeal cancer mortality rates in Mexico were low compared to most countries, and remained stable in the past two decades.

Creutzfeldt-Jakob Disease Mortality in Japan, 1979-2004: Analysis of National Death Certificate Data

BACKGROUNDTrend of the mortality rate of Creutzfeldt-Jakob disease (CJD) in Japan is still unclear. This study aimed to estimate annual crude mortality rates due to CJD and examine the CJD mortality trend in Japan during the period of 1979-2004.METHODSNational death certificate data on CJD were used (CJD coded as 046.1 for ICD-9 and A81.0 for ICD-10). Trends in age-standardized mortality rates for CJD were examined by using time series analyses including the Joinpoint regression analysis.RESULTSA total of 1,966 deaths (862 males and 1,104 females) were identified with CJD coded as the underlying-cause-of-death. The annual number of deaths and crude mortality rates peaked in 2004 at 163 (66 for males and 97 for females) deaths and 1.28 (1.06 for males and 1.48 for females) deaths per million population per year, respectively. The age-specific mortality rates rapidly increased with age between 50 and 74 years, especially among females, and sharply declined at 80+ years. Throughout the observed period, there were no significant change points, and the annual percentage changes (95% confidence intervals) were +3.09 (2.18-4.02) % for males and +3.90 (2.98-4.83) % and females. The total number of CJD deaths under 50 years of age was 131, and there was found no increase in the annual number of deaths for the past few years in this age group.CONCLUSIONCJD mortality in trend data based on death certificates has significantly increased in Japan during the period of 1979-2004.

Cancer Incidence and Mortality in the Industrial City of Sumgayit, Azerbaijan

This study, the first environmental cancer study in Azerbaijan, addressed concerns that residents of the industrial city of Sumgayit have an increased cancer burden as a consequence of intense occupational and environmental pollution from industry. Vital statistics data were used to calculate annual crude cancer incidence and mortality rates for selected cancers and regions in Azerbaijan for the years 1980-2000. Poisson regression analysis of age- and sex-specific data from 1995-2000 demonstrates an increased risk for selected cancers in Sumgayit relative to the rest of the country, as measured by adjusted rate ratios [aRR (95% CI))]: larynx 1.39 (1.04, 1.85), lung 1.67 (1.44, 1.92), bladder 2.49 (1.93, 3.22), and all sites 1.51 (1.43, 1.58). Sumgayit appears to suffer from an increased cancer burden; poor data quality and suspected underreporting, however, prevent accurate estimates of incidence or mortality rates. Construction of a modern cancer registry would be prerequisite to more detailed examinations of cancer rates in the country.

The epidemiology of international terrorism involving fatal outcomes in developed countries (1994–2003)

We aimed to describe the public health burden and epidemiology of international terrorism (i.e. involving foreign nationals) with fatal outcomes in developed countries. Data was abstracted from a United States Department of State database for 21 'established market economy' countries and 18 'former socialist economies of Europe' for 1994-2003. To put the findings in a wider context, comparisons were made with WHO data on all homicides for each country. A total of 32 international terrorist attacks causing fatalities were identified over the 10-year period. These resulted in 3299 deaths, giving a crude annual mortality rate of 0.3 per million population. The mortality burden attributable to international terrorism in these countries was 208 times less than that attributable to other homicide. Even for the country with the highest mortality burden from international terrorism (the United States), this ratio was 60. There was no statistically significant trend in the number of attacks over time, but the attack severity (in terms of deaths per attack) was higher in the latter part of the 10-year period. A number of limitations with this data set were identified. If a more rigorous definition of 'international terrorism' was used, then this would substantially reduce the total number of such attacks defined in this way. In conclusion, there is a need for better quality data and improved classification systems for describing international terrorism. Nevertheless, the available data indicates that the mortality burden from international terrorism in developed countries is small compared to that from other homicide.

Hong Kong Registry Report 2004

This report is based on data (up to 31 March 2004) from the Renal Registry of the Hospital Authority of Hong Kong, and accounts for 90-95% of all patients receiving renal replacement therapy (RRT) in the territory. Patients receiving RRT in the private sector are not included in this report.The number of patients receiving RRT was 6,054 (889 per million population [pmp]), of whom 51.6% (3,123, 451 pmp) were receiving peritoneal dialysis (PD), 10.9% (662, 97 pmp) hemodialysis (HD), and 37.5% (2,269, 334 pmp) had functioning kidney transplants. The net increase from the previous year in the number of patients receiving RRT was 3.1%. The incidence of end-stage renal failure in patients undergoing RRT was 954 (140 pmp). The median ages of existing and new patients receiving RRT were 55 and 56 years, respectively. There was a trend towards an increasing number of elderly dialysis patients. Diabetes was the third major cause of renal failure among existing RRT patients and the most common cause of renal failure in new cases. The rate of serologic positivity for hepatitis B infection in RRT patients was 9.68%, while that for hepatitis C infection was 3.28%.In Hong Kong, most patients were put on PD when RRT was required. Of all patients on dialysis, 83% were on PD, of whom 94.8% were on continuous ambulatory peritoneal dialysis (CAPD). Most CAPD patients were on disconnect systems. HD was used in 17.5% of all patients on dialysis. Of the 2,269 patients with functioning kidney transplants, 836 (36.8%) were transplanted in Hong Kong. Of these, 495 (59.2%) had undergone cadaveric kidney transplantation. Of all patients receiving RRT, 30% were receiving erythropoietin.For the year ending 31 March 2004, the annual crude mortality rate for all RRT was 10% (15.3% for PD, 13% for HD, and 1.9% for transplantation). The major causes of death were infection, cardiovascular disease, and cerebrovascular accident. The 1- and 5-year survival rates for patients with kidney transplantation performed in Hong Kong between 1 April 1997 and 31 March 2003 were 98.6% and 96.5%, respectively, for living related kidney transplants, and 96.1% and 91.2%, respectively, for cadaveric kidney transplants. The 1- and 5- year graft survival rates were 91.1% and 86.1% (death censored) and 90.5% and 85.6% (death not censored) for living related kidney transplants, and 89% and 83% (death censored) and 86% and 79% (death not censored) for cadaveric kidney transplants. The overall peritonitis rate for all chronic PD systems for the year ending 31 March 2004 was one episode per 27.7 months.