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De Meyer V, Abramowicz D, De Meester J, Collart F, Bosmans JL, Cools W, Wissing KM. Variability in the incidence of renal replacement therapy over time in Western industrialized countries: A retrospective registry analysis. PLoS One 2020; 15:e0235004. [PMID: 32584849 PMCID: PMC7316284 DOI: 10.1371/journal.pone.0235004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/06/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction A growing number of patients started renal replacement therapy (RRT) in Western industrialized countries between 1980 an early 2000s. Thereafter reports from national and international registries suggest a trend towards stabilization and sometimes a decrease in the incidence rate. Aim To investigate the differences in overall and age-specific incidence rates between industrialized countries from 1998 until 2013. Secondly, to investigate changes in incidence rates over time and their association with specific age categories. Method We extracted the unadjusted overall incidence of RRT and age-specific incidence rates from renal registry reports in Europe, the United States, Canada, Australia and New Zealand. Time trends in the incidence rate by country and age categories were analyzed by Joinpoint regression analysis. Results The incidence rate in 2013 ranged from 89 per million population (pmp) in Finland to 363 pmp in the US. Incidence rates in the lower age categories (20–64 year) were similar between countries and remained stable over time. Higher incidence countries were characterized by higher numbers of patients in both the 65–74 and ≥75 year categories starting RRT. Joinpoint analysis confirmed that most countries had significant reductions in the incidence rate at the end of the study period. These reductions were explained by lower numbers of older patients starting RRT and were observed also in countries with lower overall incidence rates. Conclusion This study confirmed different incidence rates of RRT between industrialized countries worldwide. Countries with the highest overall incidence rates also had the highest incidence rates in the oldest age categories. Since the early 2000’s the number of older patients starting RRT is either stabilizing or even decreasing in most countries. This reduction is universal and is also observed in countries with previously low incidence rates.
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Affiliation(s)
- Vicky De Meyer
- Department of Nephrology and Hypertension, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussels, Belgium
- * E-mail:
| | - Daniel Abramowicz
- Department of Nephrology, Universitair Ziekenhuis Antwerpen, Antwerpen, Belgium
- Laboratory of Medicine and Pediatrics, Universiteit Antwerpen, Antwerpen, Belgium
| | | | | | - Jean-Louis Bosmans
- Department of Nephrology, Universitair Ziekenhuis Antwerpen, Antwerpen, Belgium
| | - Wilfried Cools
- Interfaculty Center Data Processing & Statistics, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Karl Martin Wissing
- Department of Nephrology and Hypertension, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussels, Belgium
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Helve J, Kramer A, Abad-Diez JM, Couchoud C, de Arriba G, de Meester J, Evans M, Glaudet F, Grönhagen-Riska C, Heaf JG, Lezaic V, Nordio M, Palsson R, Pechter Ü, Resic H, Santamaria R, Santiuste de Pablos C, Massy ZA, Zurriaga Ó, Jager KJ, Finne P. Factors associating with differences in the incidence of renal replacement therapy among elderly: data from the ERA-EDTA Registry. Nephrol Dial Transplant 2018; 33:1428-1435. [DOI: 10.1093/ndt/gfy056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/01/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Cecile Couchoud
- Coordination nationale de REIN, Agence de la biomédecine, France
| | - Gabriel de Arriba
- Sección de Nefrologia, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Johan de Meester
- Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium
| | - Marie Evans
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Florence Glaudet
- Service de Néphrologie, Centre hospitalier et universitaire de Limoges, Limoges, France
| | | | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Visnja Lezaic
- Department of Nephrology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Maurizio Nordio
- Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy
- Nephrology Dialysis Unit, Padua, Italy
| | - Runolfur Palsson
- Division of Nephrology, Landspitali–The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ülle Pechter
- Department of Internal Medicine, University of Tartu, Estonia
| | - Halima Resic
- Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiologia, Consejeria de Sanidad, IMIB-Arrixaca, Murcia, Spain
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France
- Institut National de la Santé et de la Recherche Medical Unit 1018 team5, Research Centre in Epidemiology and Population Health, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Óscar Zurriaga
- Dirección General de Salud Pública. Conselleria de Sanitat Universal i Salut Pública, Valencia, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Patrik Finne
- Finnish Registry for Kidney Diseases, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Qureshi AR, Evans M, Stendahl M, Prütz KG, Elinder CG. The increase in renal replacement therapy (RRT) incidence has come to an end in Sweden-analysis of variations by region over the period 1991-2010. Clin Kidney J 2013; 6:352-7. [PMID: 26064505 PMCID: PMC4400478 DOI: 10.1093/ckj/sft032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 02/27/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Renal replacement therapy (RRT) incidence has increased significantly in Sweden during the past decades. This study analyses variations in time and regional trends in RRT incidence in Sweden, adjusted for age and gender, focusing on the impact change in incidence during the last decade. METHODS Using data from the Swedish Renal Registry (SRR) (21 counties in Sweden, total population 9 million), we identified all incident subjects starting RRT from 1991 through 2010. Only individuals alive following 90 days of RRT start were included. Gender- and age-specific standardized RRT incidences on an annual and regional basis were calculated, and differences between counties and variations over time were examined. We compared the overall age and gender-adjusted RRT incidence rates for Sweden by calendar year. Furthermore, we also calculated the age and gender-adjusted RRT incidence in each county during two time periods (1991-1999 versus 2000-2010). RESULTS There were 20 172 new subjects treated with RRT between January 1991 and December 2010. The most common cause of end-stage renal disease (ESRD) was diabetes (24%) and hypertension/renal vascular disease (19%), followed by glomerulonephritis (16%). Sixty-four percent of new patients were male; the median age when commencing RRT was 66 years (10-90 percentiles; 39-80). The overall standardized RRT incidence reached its peak in 2000, and slowly decreased thereafter. A decrease in RRT incidence was observed over the study period in eight regions. The standardized RRT incidence varied between the different counties, from 0.82 to 1.19. CONCLUSIONS Adjusted for demographic changes in the population, an overall decrease in RRT incidence was observed from the year 2000 onwards-suggesting that the previously reported steady increase in RRT incidence is coming to an end in Sweden. Noteworthy differences were found between counties and in 8 out of 21 counties, a decreased incidence of RRT was found. Further studies need to identify the factors that contribute to this decrease.
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Affiliation(s)
- Abdul Rashid Qureshi
- Division of Baxter Novum, Department of Clinical Science, Intervention and Technology at Karolinska Institute, Stockholm, Sweden
| | - Marie Evans
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology at Karolinska Institute, Stockholm, Sweden
| | - Maria Stendahl
- Department of Internal Medicine, Ryhov Hospital, Jönköping, Sweden
| | - Karl-Göran Prütz
- Department of Internal Medicine, Helsingborg Hospital, Helsingborg, Sweden
| | - Carl-Gustaf Elinder
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology at Karolinska Institute, Stockholm, Sweden
- Evidence Based Medicine Unit, Stockholm County Council, Stockholm, Sweden
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Visser A, Noordzij M, Gansevoort RT, Van Biesen W, Reijneveld SA, Jager KJ, de Jong PE, Izaks GJ, Dijkstra GJ, De Meester J, Hoitsma AJ, Franssen CFM. Exploration of the difference in incidence of renal replacement therapy between Flanders and the Netherlands--investigation of explanatory variables. Nephrol Dial Transplant 2011; 27:803-9. [DOI: 10.1093/ndt/gfr297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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