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Nephrol Dial Transplant. 2017 Feb 1;32(2):348-355. doi: 10.1093/ndt/gfw392.

Lifetime risk of renal replacement therapy in Europe: a population-based study using data from the ERA-EDTA Registry.

Author information

1
Department of Nephrology, Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, The Netherlands.
2
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands.
3
Medical Director, UK Renal Registry, Southmead Hospital, Bristol, UK.
4
Honorary Senior Lecturer, School of Social and Community Medicine, University of Bristol, Bristol, UK.
5
Nephrology and Dialysis Department, Brugmann Universitry Hospital, Brussels, Belgium.
6
Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
7
Finnish Registry for Kidney Diseases, Helsinki, Finland.
8
Department of Medicine, Zealand University Hospital, Roskilde, Denmark.
9
Université Paris Descartes, INSERM UMRS 1138 Team 22, APHP, Hôpital Necker Enfants Malades, Biostatistics Unit, Paris, France.
10
Austrian Dialysis and Transplant Registry, Rohr im Kremstal, Austria.
11
Division of Nephrology, Ambroise Paré Univeristy Hospital, Boulogne Billancourt/Paris, France.
12
INSERM, U-1018 Team 5 (EpReC, Renal and Cardiovascular Epidemiology), CESP, Villejeuf, France.
13
Department of Nephrology and Dialysis and Hypertension, Dutch-Speaking Belgian Renal Registry Sint-Niklaas, Belgium.
14
Scottish Renal Registry, Glasgow, UK.
15
The Norwegian Renal Registry, Department of Nephrology, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Olso, Norway.

Abstract

Background:

Upcoming KDIGO guidelines for the evaluation of living kidney donors are expected to move towards a personal risk-based evaluation of potential donors. We present the age and sex-specific lifetime risk of renal replacement therapy (RRT) for end-stage renal disease in 10 European countries.

Methods:

We defined lifetime risk of RRT as the cumulative incidence of RRT up to age 90 years. We obtained RRT incidence rates per million population by 5-year age groups and sex using data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, and used these to estimate the cumulative incidence of RRT, adjusting for competing mortality risk.

Results:

Lifetime risk of RRT varied from 0.44% to 2.05% at age 20 years and from 0.17% to 1.59% at age 70 years across countries, and was twice as high in men as in women. Lifetime RRT risk decreased with age, ranging from an average of 0.77% to 0.44% in 20- to- 70-year-old women, and from 1.45% to 0.96% in 20- to- 70-year-old men. The lifetime risk of RRT increased slightly over the past decade, more so in men than in women. However, it appears to have stabilized or even decreased slightly in more recent years.

Conclusions:

The lifetime risk of RRT decreased with age, was lower in women as compared with men of equal age and varied considerably throughout Europe. Given the substantial differences in lifetime risk of RRT between the USA and Europe, country-specific estimates should be used in the evaluation and communication of the risk of RRT for potential living kidney donors.

KEYWORDS:

end-stage renal disease, lifetime risk, living kidney donor, mortality, renal replacement therapy

PMID:
28031344
DOI:
10.1093/ndt/gfw392
[Indexed for MEDLINE]

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