Cécile Vigneau1, Anne Kolko2, Bénédicte Stengel3, Christian Jacquelinet4, Paul Landais5, Philippe Rieu6, Sahar Bayat7, Cécile Couchoud4. 1. Service de néphrologie, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Université de Rennes 1, 2, avenue Léon-Bernard, 35000 Rennes, France. Electronic address: cecile.vigneau@chu-rennes.fr. 2. AURA, 185-191, rue Raymond-Loserand, 75014 Paris, France. 3. CESP, Inserm U1018, université Paris-Sud, UVSQ, université Paris-Saclay, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France. 4. REIN registry, agence de la biomédecine, 1, avenue du Stade-de-France, 93212 Plaine-Saint-Denis, France. 5. UPRES EA2415, Clinical Research Institute, Montpellier University and Biostatistics, Epidemiology and Public Health department, Nîmes University Hospital, 641, avenue du Doyen-Gaston-Giraud, 34093 Nîmes, France. 6. Service de néphrologie, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France. 7. EHESP, Sorbonne Paris Cité, EA MOS France, 15, avenue Léon-Bernard, 35000 Rennes, France.
Abstract
BACKGROUND: The incidence rate of renal replacement therapy (RRT) for end-stage renal disease (ESRD) is decreasing in several countries, but not in France. We studied the RRT trends in mainland France from 2005 to 2014 to understand the reasons for this discrepancy and determine the effects of ESRD management changes. METHODS: Data were extracted from the French Renal Epidemiology and Information Network registry. Time trends of RRT incidence and prevalence rates, patients' clinical and treatment characteristics were analysed using the Joinpoint regression program and annual percentage changes. Survival within the first year of RRT was analysed using Kaplan-Meier estimates for 4 periods of time. RESULTS: The overall age- and gender-adjusted RRT incidence rate increased from 144 to 159 individuals per million inhabitants (pmi) (+0.8% per year; 95% CI: 0.5-1.2) and the prevalence from 903 to 1141 pmi (+2.4% per year; 95% CI: 2.2-2.7). This increase concerned exclusively ESRD associated with type 2 diabetes (+4.0%; 3.4-4.6) and mostly elderly men. Despite patient aging and increasing comorbidity burden and a persistent 30% rate of emergency dialysis start, the one-year survival rate slightly improved from 82.1% (81.4-82.8) to 83.8% (83.3-84.4). Pre-emptive wait listing for renal transplantation and the percentage of wait-listed patients within one year after dialysis start strongly increased (from 5.6% to 15.5% and from 29% to 39%, respectively). CONCLUSION: Kidney transplantation and survival significantly improved despite the heavier patient burden. However, the rise in type 2 diabetes-related ESRD and the stable high rate of emergency dialysis start remain major issues.
BACKGROUND: The incidence rate of renal replacement therapy (RRT) for end-stage renal disease (ESRD) is decreasing in several countries, but not in France. We studied the RRT trends in mainland France from 2005 to 2014 to understand the reasons for this discrepancy and determine the effects of ESRD management changes. METHODS: Data were extracted from the French Renal Epidemiology and Information Network registry. Time trends of RRT incidence and prevalence rates, patients' clinical and treatment characteristics were analysed using the Joinpoint regression program and annual percentage changes. Survival within the first year of RRT was analysed using Kaplan-Meier estimates for 4 periods of time. RESULTS: The overall age- and gender-adjusted RRT incidence rate increased from 144 to 159 individuals per million inhabitants (pmi) (+0.8% per year; 95% CI: 0.5-1.2) and the prevalence from 903 to 1141 pmi (+2.4% per year; 95% CI: 2.2-2.7). This increase concerned exclusively ESRD associated with type 2 diabetes (+4.0%; 3.4-4.6) and mostly elderly men. Despite patient aging and increasing comorbidity burden and a persistent 30% rate of emergency dialysis start, the one-year survival rate slightly improved from 82.1% (81.4-82.8) to 83.8% (83.3-84.4). Pre-emptive wait listing for renal transplantation and the percentage of wait-listed patients within one year after dialysis start strongly increased (from 5.6% to 15.5% and from 29% to 39%, respectively). CONCLUSION: Kidney transplantation and survival significantly improved despite the heavier patient burden. However, the rise in type 2 diabetes-related ESRD and the stable high rate of emergency dialysis start remain major issues.
Authors: Cindy M Padilla; Maxime Raffray; Adélaïde Pladys; Cécile Vigneau; Sahar Bayat Journal: Int J Environ Res Public Health Date: 2018-12-21 Impact factor: 3.390
Authors: Maxime Raffray; Sahar Bayat; Arnaud Campéon; Laëtitia Laude; Cécile Vigneau Journal: Int J Environ Res Public Health Date: 2019-12-09 Impact factor: 3.390