Harding JL, Morton JI, Shaw JE, et al. - This retrospective cohort study unveils changes in excess mortality for individuals suffering from diabetes-related end-stage kidney disease (ESKD-DM) in the US and Australia. In view of the growing burden of diabetes in the population, decreasing excess mortality risk in the ESKD-DM population should be the priority.

• Using the United States Renal Data System and the Australia and New Zealand Dialysis and Transplant Registry, 2002–2013, this study identified adults (ages 20–84) undergoing renal replacement therapy for ESKD-DM in the US (n = 1,178,860) and Australia (n = 10,381).

• For persons with ESKD-DM managed with dialysis or transplant, a reduction in the excess mortality has been observed in the US and Australia, however, progress has stalled from ∼2013 in the US.

• Nevertheless, ESKD-DM has mortality more than nine times higher than the general population, with important variations across subgroups.

• Higher excess mortality was observed in women (vs men), younger (vs older) adults, dialysis (vs transplant) patients, and in Asian or Pacific Islanders and American Indian or Alaskan Natives (vs Whites and Blacks).