Life Expectancy While on Dialysis

Your kidneys help clear waste from your blood. Different diseases can stop your kidneys from working properly. The damage to the kidneys can turn into chronic kidney disease. You may eventually have kidney failure.¹

Kidney failure is a term for when the kidneys have mostly stopped working. When this happens, dialysis can be used to clear waste from the blood. Dialysis uses a machine to clean the blood. The goal of dialysis is to do the job of the kidneys. But it cannot replace fully functioning kidneys.^1,2

Being on dialysis may affect how long you will live. This is also called your life expectancy. The average life expectancy of someone on dialysis is 5 to 10 years. But there are many factors that play a role. Some people can live 30 years after starting dialysis.^1,2

Factors that can influence life expectancy include:^3-5

• Age
• Race
• Other diseases you may have, like diabetes or high blood pressure
• The type of dialysis you get
• How often you get dialysis
• The type of disease that caused your kidney failure

Cause of death in people on dialysis

People on dialysis have a higher chance of death (mortality rate). The USRDS (United States Renal Data System) puts together data on chronic kidney disease. It looks at medical claims to get this information. According to the USRDS 2023 report, some common causes of death in people on dialysis are:^1,4,5

• Cardiac arrest – This happens when the heart stops pumping blood. This was the cause of death in about 30 to 40 percent of people on dialysis who died in 2021.
• Withdrawal – Some people choose to stop their dialysis treatment. But people with kidney failure cannot survive without dialysis. Withdrawal was the cause of death in about 12 percent of the deaths in people on dialysis.
• Infections – People on dialysis have a higher chance of getting infections. Use of needles for dialysis makes it more likely that bacteria can enter the blood and cause infections. In 2021, about 6 to 8 percent of deaths among people on dialysis were due to infections. An additional 8 percent of deaths in people on dialysis were due to COVID-19.

Mortality rates in different groups

Dialysis affects life expectancy. But not everyone is affected similarly. And the mortality rate can be different in different groups. The USRDS report includes data on which groups are at a higher risk. Some of the things that affect mortality rate are:⁵

• Age: There is a direct relationship between age and mortality rate. Older people on dialysis have a higher mortality rate than younger people. For example, people between the ages of 65 to 74 have a 30 percent lower mortality rate than people 75 and over.
• Race/ethnicity: White people on dialysis have a higher mortality rate than Hispanic or Black people. In 2021, the mortality rate for white people was 40 percent higher than for Hispanic or Black people.
• Type of dialysis: There are 2 main types of dialysis: hemodialysis and peritoneal dialysis. Peritoneal dialysis has a 15 percent lower mortality rate compared to hemodialysis.

Before 2019, the mortality rate for people on dialysis declined steadily. From 2011 to 2019, the mortality rate reduced by 11 percent. There was an increase in the mortality rate from 2019 to 2021. This increase is likely due to the COVID-19 pandemic. As the effects of the pandemic lessen and treatments become better, mortality rates will likely continue to decrease.⁵