Life expectancy in kidney failure
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Life Expectancy and Kidney Failure: Key Predictors and Trends
Life expectancy in people with kidney failure is significantly reduced compared to the general population, and this reduction begins even before reaching end-stage kidney disease. The degree of kidney function loss, measured by estimated glomerular filtration rate (eGFR), and the amount of protein in the urine are strong predictors of both kidney outcomes and overall survival. Data from large registries show that life expectancy starts to decline when eGFR drops below 60 ml/min, and this decline continues as kidney function worsens 13.
Life Expectancy by Stage of Kidney Function
For adults, life expectancy decreases as kidney function declines. For example, at age 40, men and women with normal kidney function (eGFR ≥60) can expect to live about 30.5 and 34.6 more years, respectively. However, with moderate kidney impairment (eGFR 30–44), life expectancy drops to 14.5 years for men and 16.5 years for women. In severe kidney failure (eGFR 15–29), life expectancy is about 10.4 years for men and 9.1 years for women . This pattern is consistent across different populations and age groups 13.
Impact of Kidney Failure in Children
Children with kidney failure also experience a significant reduction in life expectancy. Studies show that children who develop kidney failure can lose between 16 and 32 years of potential life, with the greatest loss seen in those who develop kidney failure at a younger age and in female patients. Most children eventually receive a kidney transplant, but they still spend more years on dialysis than with a functioning transplant . Female children and those with earlier onset of kidney failure are particularly affected 28.
Dialysis vs. Kidney Transplant: Survival Differences
Patients on dialysis have a much shorter life expectancy compared to those who receive a kidney transplant. For example, one study found that the projected life expectancy for a patient on dialysis was about 5.8 years, while a successful kidney transplant increased this to 17.2 years—nearly tripling survival . On average, dialysis patients lose about 9 years of potential life, while transplant recipients lose only about 2.2 years, a reduction of over 75% . These findings are consistent across different countries and age groups 459.
Sex Differences in Life Expectancy
Women with kidney failure tend to lose more years of life compared to men, especially when compared to the general population. The difference is most pronounced in younger patients and those who die from cardiovascular disease. Kidney transplantation reduces, but does not completely eliminate, this gap 289.
Quality of Life and Perceptions of Prognosis
Quality of life is an important consideration for people with kidney failure. Patients who choose conservative (non-dialysis) management often maintain similar mental health and life satisfaction compared to those on dialysis, though their median survival is about 13 months shorter after adjusting for other health factors . There is also a significant mismatch between how long dialysis patients expect to live and the estimates provided by their healthcare providers, with patients often being more optimistic. These perceptions influence treatment choices and priorities, highlighting the need for clear and honest discussions about prognosis .
Conclusion
Kidney failure leads to a substantial reduction in life expectancy for both adults and children, with the degree of kidney function loss being a key predictor. Dialysis is associated with a significant loss of potential life years, while kidney transplantation greatly improves survival. Women and those who develop kidney failure at a younger age are particularly affected. Ongoing improvements in treatment and management, especially cardiovascular risk reduction and access to transplantation, continue to improve outcomes, but the burden of lost life years remains high. Clear communication about prognosis is essential to help patients make informed decisions about their care 12345678+2 MORE.
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