**2. Morbidity/mortality**

Chronic renal failure is associated with a very high morbidity and hospitalization rate, likely due to existing comorbid conditions, such as hypertension, coronary artery disease, and peripheral vascular disease. The first-year age-adjusted mortality rate of patients on dialysis is 9.4%, the two-year mortality rate is 32.3%, and the 5-year mortality rate is 60.8% (3). ESRD patients with diabetes have a first-year mortality rate of 23% (3). In patients with ESRD, cardiovascular disease is the primary cause of death, followed by sepsis and cerebrovascular disease. The dialysis population in the United States has a 10- to 20-fold higher risk of death due to cardiovascular complications than the general population after adjusting for age, race, and sex. The relative risk with respect to the general population is much higher in younger patients, with cardiovascular event rates in ESRD patients in their 20s equivalent to the event rates in the general population in their 80s (3). Increased understanding of the disease process, new insights into pathogenic mechanisms, and new therapeutic options are emerging that may improve survival rates and quality of life for patients with ESRD.
