[Network and epidemiologic information in nephrology: Kidney report 2009].

In 2009, 8,560 patients with end-stage renal disease living in 20 regions (Alsace, Auvergne, Bourgogne, Bretagne, Centre, Champagne-Ardenne, Corse, Haute-Normandie, Ile de France, la Réunion, Languedoc-Roussillon, Limousin, Lorraine, Midi- Pyrénées, Nord-Pas de Calais, Pays de Loire, Picardie, Poitou- Charentes, Provence-Alpes Côte d'Azur and Rhône-Alpes) covering 57 million inhabitants (89% of the French population), started renal replacement therapy (dialysis or preemptive graft): median age was 70,2 years ; 3,4% had a preemptive graft. The overall crude annual incidence rate of renal replacement therapy for end-stage renal disease was 150 per million population (pmp), with significant differences in sex and age-adjusted incidence across regions (99 to 389 pmh). At initiation, more than one patient out of two had at least one cardiovascular disease and 41% diabetes (92% Type 2 non-insulin-dependent diabetes). On December 31, 2009, 33,558 patients living in the above 20 regions were on dialysis : median age was 70,5 years. On December 31, 2009, 29,181 patients were living with a functioning graft : median age was 54,8 years. In these 20 regions, the overall prevalence of dialysis was 588 pmp, that of renal graft, 510 pmp and the overall rate of renal replacement therapy for end stage renal disease, 1,098 pmp with significant differences in age-adjusted prevalence across regions (809 to 2,709 pmh). In the 2002-2009 cohort of 43,433 incident patients, the overall one-year survival rate was 83%, 45% at 6 years. Survival decreased with age, but remained above 50% at 2 years in patients older than 75 at RRT initiation. Among the 8,688 new patients starting dialysis in 2009 in 23 regions (the 20 regions mentioned above, plus Aquitaine, Pays de Loire and Guadeloupe), 5% had a BMI lower than 18,5 kg/m² and 20% a BMI higher than 30. At initiation, 66% had a haemoglobin value lower than 11 g/l and 10% an albumin value lower than 25 g/l. The first haemodialysis was started in emergency in 33 % of the patients and with a catheter in 54 %. On December 31, 2009, 7 % treated in the dialysis units of the 22 regions (the 20 regions mentioned above, plus Aquitaine and Pays de Loire) received peritoneal dialysis, of which 40% were treated with automated peritoneal dialysis. 95% of the patients on haemodialysis had 3 sessions per week, with a median duration of 4 hours. In the 2002-2009 cohort of incident patients in 18 regions under 60 years, the probability to be at least once on the waiting list for a renal graft is 50% at 15,6 months. In 2009, 2,750 patients received a renal graft. On December 31, 2009, 7,272 patients were on the waiting list for a renal graft in the transplantation centres of the 22 regions. The analysis of the flows between treatments indicates that the proportion of the transplanted patients among RTT patients is increasing. The main source for transplantation is the outcenter patients.