Jilske A Huijben1, Anneke Kramer1, Julia Kerschbaum2, Johan de Meester3, Frederic Collart4, Olga Lucía Rodríguez Arévalo5,6, Jaakko Helve7,8, Mathilde Lassalle9, Runolfur Palsson10,11, Marc Ten Dam12, Anna Casula13, Shona Methven14, Alberto Ortiz15, Pietro Manuel Ferraro16,17, Mårten Segelmark18,19, Pablo Ucio Mingo20, Mustafa Arici21, Anna Varberg Reisæter22, Maria Stendahl19, Vianda S Stel1, Kitty J Jager1. 1. Department of Medical Informatics, ERA-EDTA Registry, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. 2. Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV - Nephrology and Hypertension, Medical University Innsbruck, Austria. 3. Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium. 4. French-Belgian ESRD Registry (GNFB), Brussels, Belgium. 5. Valencia Region Renal Registry, Dirección General de Salut Publica i Adiccions, Valencia, Spain. 6. Doctoral student of the Technologies for Health and Well-being program, Universidad Politécnica de Valencia, Valencia, Spain. 7. Finnish Registry for Kidney Diseases, Helsinki, Finland. 8. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 9. REIN Registry, Agence de la Biomédecine, Saint-Denis La Plaine, France. 10. Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 11. Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 12. Dutch Registry RENINE, Nefrovisie, Utrecht, The Netherlands. 13. UK Renal Registry, the Renal Association, Bristol, UK. 14. Department of Renal Medicine, Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, UK. 15. School of Medicine, IIS-Fundacion Jimenez Diaz, University Autonoma of Madrid, FRIAT and REDINREN, Madrid, Spain. 16. U.O.S. Terapia Conservativa della Malattia Renale Cronica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 17. Università Cattolica del Sacro Cuore, Rome, Italy. 18. Department of Clinical Sciences, Division of Nephrology, Lund University and Skane University Hospital, Lund, Sweden. 19. Swedish Renal Registry, Department of Internal Medicine, Ryhov County Hospital, Jönköping, Sweden. 20. Coordinador Autonómico de Trasplantes de Castilla y León, Dirección General de Planificación y Asistencia Sanitaria, Valladolid, Castilla y León, Spain. 21. Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. 22. Department of Transplantation Medicine, Oslo University hospital, Rikshospitalet, Norway.
Abstract
INTRODUCTION: The aim of this study was to describe the trends in the incidence, prevalence and survival of patients on kidney replacement therapy (KRT) for end-stage kidney disease (ESKD) across Europe from 2008 to 2017. METHODS: Data from renal registries in 9 countries and 16 regions that provided individual patient data to the ERA Registry from 2008 to 2017 were included. These registries cover 34% of the general population in Europe. Crude and standardized incidence and prevalence per million population (pmp) were determined. Trends over time were studied using Joinpoint regression. Survival probabilities were estimated using Kaplan-Meier analysis and hazard ratios (HRs) using Cox regression analysis. RESULTS: The standardized incidence of KRT was stable (annual percentage change [APC]: -1.48 [-3.15; 0.21]) from 2008 (146.0 pmp) to 2011 (141.6 pmp), followed by a slight increase (APC: 1.01 [0.43; 1.60]) to 148.0 pmp in 2017, although trends in incidence varied across countries. This increase was primarily due to a rise in the incidence of KRT in men older than 65 years. Moreover, as a cause of kidney failure, diabetes mellitus is increasing. The standardized prevalence increased from 2008 (990.0 pmp) to 2017 (1166.8 pmp) (APC: 1.82 [1.75; 1.89]). Patient survival on KRT improved in the time period 2011-2013 compared with 2008-2010 (adjusted HR: 0.94 [0.93; 0.95). CONCLUSION: This study showed an overall increase in the incidence and prevalence of KRT for ESKD as well as an increase in the KRT patient survival over the last decade in Europe.
INTRODUCTION: The aim of this study was to describe the trends in the incidence, prevalence and survival of patients on kidney replacement therapy (KRT) for end-stage kidney disease (ESKD) across Europe from 2008 to 2017. METHODS: Data from renal registries in 9 countries and 16 regions that provided individual patient data to the ERA Registry from 2008 to 2017 were included. These registries cover 34% of the general population in Europe. Crude and standardized incidence and prevalence per million population (pmp) were determined. Trends over time were studied using Joinpoint regression. Survival probabilities were estimated using Kaplan-Meier analysis and hazard ratios (HRs) using Cox regression analysis. RESULTS: The standardized incidence of KRT was stable (annual percentage change [APC]: -1.48 [-3.15; 0.21]) from 2008 (146.0 pmp) to 2011 (141.6 pmp), followed by a slight increase (APC: 1.01 [0.43; 1.60]) to 148.0 pmp in 2017, although trends in incidence varied across countries. This increase was primarily due to a rise in the incidence of KRT in men older than 65 years. Moreover, as a cause of kidney failure, diabetes mellitus is increasing. The standardized prevalence increased from 2008 (990.0 pmp) to 2017 (1166.8 pmp) (APC: 1.82 [1.75; 1.89]). Patient survival on KRT improved in the time period 2011-2013 compared with 2008-2010 (adjusted HR: 0.94 [0.93; 0.95). CONCLUSION: This study showed an overall increase in the incidence and prevalence of KRT for ESKD as well as an increase in the KRT patient survival over the last decade in Europe.