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The increase in renal replacement therapy (RRT) incidence has come to an end in Sweden-analysis of variations by region over the period 1991-2010.

Qureshi AR, Evans M, Stendahl M, Prütz KG, Elinder CG - Clin Kidney J (2013)

Bottom Line: A decrease in RRT incidence was observed over the study period in eight regions.Noteworthy differences were found between counties and in 8 out of 21 counties, a decreased incidence of RRT was found.Further studies need to identify the factors that contribute to this decrease.

View Article: PubMed Central - PubMed

Affiliation: Division of Baxter Novum, Department of Clinical Science , Intervention and Technology at Karolinska Institute , Stockholm , Sweden.

ABSTRACT

Background: Renal replacement therapy (RRT) incidence has increased significantly in Sweden during the past decades. This study analyses variations in time and regional trends in RRT incidence in Sweden, adjusted for age and gender, focusing on the impact change in incidence during the last decade.

Methods: Using data from the Swedish Renal Registry (SRR) (21 counties in Sweden, total population 9 million), we identified all incident subjects starting RRT from 1991 through 2010. Only individuals alive following 90 days of RRT start were included. Gender- and age-specific standardized RRT incidences on an annual and regional basis were calculated, and differences between counties and variations over time were examined. We compared the overall age and gender-adjusted RRT incidence rates for Sweden by calendar year. Furthermore, we also calculated the age and gender-adjusted RRT incidence in each county during two time periods (1991-1999 versus 2000-2010).

Results: There were 20 172 new subjects treated with RRT between January 1991 and December 2010. The most common cause of end-stage renal disease (ESRD) was diabetes (24%) and hypertension/renal vascular disease (19%), followed by glomerulonephritis (16%). Sixty-four percent of new patients were male; the median age when commencing RRT was 66 years (10-90 percentiles; 39-80). The overall standardized RRT incidence reached its peak in 2000, and slowly decreased thereafter. A decrease in RRT incidence was observed over the study period in eight regions. The standardized RRT incidence varied between the different counties, from 0.82 to 1.19.

Conclusions: Adjusted for demographic changes in the population, an overall decrease in RRT incidence was observed from the year 2000 onwards-suggesting that the previously reported steady increase in RRT incidence is coming to an end in Sweden. Noteworthy differences were found between counties and in 8 out of 21 counties, a decreased incidence of RRT was found. Further studies need to identify the factors that contribute to this decrease.

No MeSH data available.


Related in: MedlinePlus

(A) The incidence of ESRD in male patients in Sweden 1991–2010 in five age groups. (B) The incidence of ESRD in female patients in Sweden 1991–2010 in five age groups.
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SFT032F3: (A) The incidence of ESRD in male patients in Sweden 1991–2010 in five age groups. (B) The incidence of ESRD in female patients in Sweden 1991–2010 in five age groups.

Mentions: When normalizing the RRT incidence to that of 1991, we observed that the total normalized incidence RRT reached its peak in the calendar year of 2000 (Figure 1), while there was a decreasing trend thereafter. As shown in Figure 2, we found remarkably higher standardized incidence rates of RRT (1991–2010) in men compared with female. We then divided the follow-up period into four 5-year periods to observe the standardized incidence rate in female (Figure 3A) and male (Figure 3B), respectively. We noticed that there was a decrease in the standardized incidence rate for both female and male 65–74 year olds in 2001–2005 and 2006–2010 compared with 1991–2000. For patients >75 years, there was an increasing trend for male patients in both 2001–2005 and 2006–2010 and likewise for female. The standardized incidence rate was relatively stable or decreased among female and male patients aged <65 years for 1991–2010 (Figure 3A and B).Fig. 1.


The increase in renal replacement therapy (RRT) incidence has come to an end in Sweden-analysis of variations by region over the period 1991-2010.

Qureshi AR, Evans M, Stendahl M, Prütz KG, Elinder CG - Clin Kidney J (2013)

(A) The incidence of ESRD in male patients in Sweden 1991–2010 in five age groups. (B) The incidence of ESRD in female patients in Sweden 1991–2010 in five age groups.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400478&req=5

SFT032F3: (A) The incidence of ESRD in male patients in Sweden 1991–2010 in five age groups. (B) The incidence of ESRD in female patients in Sweden 1991–2010 in five age groups.
Mentions: When normalizing the RRT incidence to that of 1991, we observed that the total normalized incidence RRT reached its peak in the calendar year of 2000 (Figure 1), while there was a decreasing trend thereafter. As shown in Figure 2, we found remarkably higher standardized incidence rates of RRT (1991–2010) in men compared with female. We then divided the follow-up period into four 5-year periods to observe the standardized incidence rate in female (Figure 3A) and male (Figure 3B), respectively. We noticed that there was a decrease in the standardized incidence rate for both female and male 65–74 year olds in 2001–2005 and 2006–2010 compared with 1991–2000. For patients >75 years, there was an increasing trend for male patients in both 2001–2005 and 2006–2010 and likewise for female. The standardized incidence rate was relatively stable or decreased among female and male patients aged <65 years for 1991–2010 (Figure 3A and B).Fig. 1.

Bottom Line: A decrease in RRT incidence was observed over the study period in eight regions.Noteworthy differences were found between counties and in 8 out of 21 counties, a decreased incidence of RRT was found.Further studies need to identify the factors that contribute to this decrease.

View Article: PubMed Central - PubMed

Affiliation: Division of Baxter Novum, Department of Clinical Science , Intervention and Technology at Karolinska Institute , Stockholm , Sweden.

ABSTRACT

Background: Renal replacement therapy (RRT) incidence has increased significantly in Sweden during the past decades. This study analyses variations in time and regional trends in RRT incidence in Sweden, adjusted for age and gender, focusing on the impact change in incidence during the last decade.

Methods: Using data from the Swedish Renal Registry (SRR) (21 counties in Sweden, total population 9 million), we identified all incident subjects starting RRT from 1991 through 2010. Only individuals alive following 90 days of RRT start were included. Gender- and age-specific standardized RRT incidences on an annual and regional basis were calculated, and differences between counties and variations over time were examined. We compared the overall age and gender-adjusted RRT incidence rates for Sweden by calendar year. Furthermore, we also calculated the age and gender-adjusted RRT incidence in each county during two time periods (1991-1999 versus 2000-2010).

Results: There were 20 172 new subjects treated with RRT between January 1991 and December 2010. The most common cause of end-stage renal disease (ESRD) was diabetes (24%) and hypertension/renal vascular disease (19%), followed by glomerulonephritis (16%). Sixty-four percent of new patients were male; the median age when commencing RRT was 66 years (10-90 percentiles; 39-80). The overall standardized RRT incidence reached its peak in 2000, and slowly decreased thereafter. A decrease in RRT incidence was observed over the study period in eight regions. The standardized RRT incidence varied between the different counties, from 0.82 to 1.19.

Conclusions: Adjusted for demographic changes in the population, an overall decrease in RRT incidence was observed from the year 2000 onwards-suggesting that the previously reported steady increase in RRT incidence is coming to an end in Sweden. Noteworthy differences were found between counties and in 8 out of 21 counties, a decreased incidence of RRT was found. Further studies need to identify the factors that contribute to this decrease.

No MeSH data available.


Related in: MedlinePlus