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Nephrol Dial Transplant. 2014 Aug;29(8):1494-9. doi: 10.1093/ndt/gft390. Epub 2013 Oct 28.

A population approach to renal replacement therapy epidemiology: lessons from the EVEREST study.

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Richard Bright Renal Unit, Southmead Hospital, Bristol, UK School of Clinical Sciences, University of Bristol, Bristol, UK.
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.


The marked variation that exists in renal replacement therapy (RRT) epidemiology between countries and within countries requires careful systematic examination if the root causes are to be understood. While individual patient-level studies are undoubtedly important, there is a complementary role for more population-level, area-based studies--an aetiological approach. The EVEREST Study adopted such an approach, bringing RRT incidence rates, survival and modality mix together with macroeconomic factors, general population factors and renal service organizational factors for up to 46 countries. This review considers the background to EVEREST, its key results and then the main methodological lessons and their potential application to ongoing work.


aetiology; epidemiology; macroeconomics; renal replacement therapy; renal service organization

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