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Title: The changing trends and outcomes in renal replacement therapy: data from the ERA-EDTA Registry.
Authors: Pippias, Maria
Jager, Kitty J
Kramer, Anneke
Leivestad, Torbjørn
Sánchez, Manuel Benítez
Caskey, Fergus J
Collart, Frederic
Couchoud, Cécile
Dekker, Friedo W
Finne, Patrik
Fouque, Denis
Heaf, James G
Hemmelder, Marc H
Kramar, Reinhard
De Meester, Johan
Noordzij, Marlies
Palsson, Runolfur
Pascual, Julio
Zurriaga, Oscar
Wanner, Christoph
Stel, Vianda S
Keywords: Europe;end-stage renal disease;incidence;renal replacement therapy;survival
metadata.dc.subject.mesh: Aged
Cohort Studies
Kidney Failure, Chronic
Middle Aged
Renal Replacement Therapy
Time Factors
Issue Date: 11-Sep-2015
Abstract: This study examines the time trends in incidence, prevalence, patient and kidney allograft survival and causes of death (COD) in patients receiving renal replacement therapy (RRT) in Europe. Eighteen national or regional renal registries providing data to the European Renal Association-European Dialysis and Transplant Association Registry between 1998 and 2011 were included. Incidence and prevalence time trends between 2001 and 2011 were studied with Joinpoint and Poisson regression. Patient and kidney allograft survival and COD between 1998 and 2011 were analysed using Kaplan-Meier and competing risk methods and Cox regression. From 2001 to 2008, the adjusted incidence of RRT rose by 1.1% (95% CI: 0.6, 1.7) annually to 131 per million population (pmp). During 2008-2011, the adjusted incidence fell by 2.2% (95% CI: -4.2, -0.2) annually to 125 pmp. This decline occurred predominantly in patients aged 45-64 years, 65-74 years and in the primary renal diseases diabetes mellitus type 1 and 2, renovascular disease and glomerulonephritis. Between 2001 and 2011, the overall adjusted prevalence increased from 724 to 1032 pmp (+3.3% annually, 95% CI: 2.8, 3.8). The adjusted 5-year patient survival on RRT improved between 1998-2002 and 2003-2007 [adjusted hazard ratio (HRa) 0.85, 95% CI: 0.84, 0.86]. Comparing these time periods, the risk of cardiovascular deaths fell by 25% (HRa 0.75, 95% CI: 0.74, 0.77). However the risk of malignant death rose by 9% (HRa 1.09, 95% CI: 1.03, 1.16) in patients ≥65 years. This European study shows a declining RRT incidence, particularly in patients aged 45-64 years, 65-74 years and secondary to diabetic nephropathy. Encouragingly, the adjusted RRT patient survival continues to improve. The risk of cardiovascular death has decreased, though the risk of death from malignancy has increased in the older population.
metadata.dc.identifier.doi: 10.1093/ndt/gfv327
Appears in Collections:Producción 2020

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