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2012 ERA-EDTA Registry Annual Report: cautious optimism on outcomes, concern about persistent inequalities and data black-outs.

Gonzalez-Espinoza L, Ortiz A - Clin Kidney J (2015)

Bottom Line: Living in Greece, Belgium (French- or Dutch-speaking) or Portugal (the GBP countries) is associated with higher chances of initiating RRT than living in other European countries.Unravelling the underlying reasons is an urgent research need: only an understanding of the causes will allow correction of the problem.Unavailability of data from some large countries (e.g. Germany and Italy) is not helpful.

View Article: PubMed Central - PubMed

Affiliation: IIS-Fundacion Jimenez Diaz, School of Medicine , Universidad Autonoma de Madrid , Madrid , Spain ; Fundacion Renal Iñigo Alvarez de Toledo-IRSIN and REDINREN , Madrid , Spain.

ABSTRACT
The 2012 ERA-EDTA Registry Annual Report contains both good news and bad news. On the bright side, the 2-year survival of patients starting renal replacement therapy (RRT) for chronic kidney disease (CKD), on dialysis or receiving a living-related kidney transplantation, has progressively increased to 82.2, 79.7 and 98.3%, respectively, whereas for cadaveric kidney transplantation it remains stable (96.0-96.1%). On the dark side, inequalities persist between European citizens in access to renal transplantation and in incidence and prevalence of RRT. Living in Greece, Belgium (French- or Dutch-speaking) or Portugal (the GBP countries) is associated with higher chances of initiating RRT than living in other European countries. The adjusted RRT incidence for GBP countries was 188, 201-174 and 220* (* unadjusted) pmp in 2012, respectively (versus 122, 114 and 97 pmp in the Netherlands or two Spanish regions bordering Portugal). In lower income countries, a low RRT incidence may represent lack of access to needed healthcare (e.g. Montenegro 26 pmp). However, how can the high incidence and prevalence of RRT in the GBP countries be explained? Do GBP citizens have access to RRT that is denied, rejected or considered unnecessary in other high income countries? Does the GBP healthcare system fail to prevent progression of CKD? Do local genetic or environmental factors favour CKD progression? Unravelling the underlying reasons is an urgent research need: only an understanding of the causes will allow correction of the problem. Unavailability of data from some large countries (e.g. Germany and Italy) is not helpful.

No MeSH data available.


Related in: MedlinePlus

Mean 2010–12 adjusted incidence and prevalence data for selected countries and regions. (A) Incidence of RRT, pmp at Day 1 standardized to the age and gender distribution of the EU27 population. (B) Incidence of RRT, pmarp at Day 1 for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. (C) Prevalence of RRT, pmp on 31 December, standardized to the age and gender distribution of the EU27 population. (D) Prevalence of RRT, pmarp on 31 December, for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. Note the difference in scale between whole population values (A and C) and over 75-year-old values (B and D). Data expressed as mean + SD of years 2010–12. Nd: no data, *unadjusted. Belgium-D: Belgium Dutch-speaking (Flanders), Belgium-F: Belgium French-speaking (Wallonia).
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SFV035F2: Mean 2010–12 adjusted incidence and prevalence data for selected countries and regions. (A) Incidence of RRT, pmp at Day 1 standardized to the age and gender distribution of the EU27 population. (B) Incidence of RRT, pmarp at Day 1 for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. (C) Prevalence of RRT, pmp on 31 December, standardized to the age and gender distribution of the EU27 population. (D) Prevalence of RRT, pmarp on 31 December, for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. Note the difference in scale between whole population values (A and C) and over 75-year-old values (B and D). Data expressed as mean + SD of years 2010–12. Nd: no data, *unadjusted. Belgium-D: Belgium Dutch-speaking (Flanders), Belgium-F: Belgium French-speaking (Wallonia).

Mentions: The recent publication of the 2012 ERA-EDTA Registry Annual Report contains both good news and bad news [1]. On the bright side, survival of patients on renal replacement therapy (RRT) for end-stage chronic kidney disease (CKD) is progressively increasing as observed when 2012 data are compared with 2011 and 2010 data [1–3] (Figure 1). On the dark side, the 2012 report shows persistence of inequalities in the incidence and prevalence of RRT and in access to optimal therapeutic modalities, such as kidney transplantation, across different European countries (Figures 2 and 3), that appear to be unexplained by demography or by per capita gross domestic product (Figure 4). Three countries, Greece, Belgium and Portugal, the GBP (pronounced GeeBeeP) countries, top the charts of incidence and prevalence of RRT one more year. These differences may point out serious issues with public health planning, access or provision of predialysis healthcare or access to RRT in Europe—although it is yet unclear whether the problem lies with the GBPs or the rest of Europe.Fig. 1.


2012 ERA-EDTA Registry Annual Report: cautious optimism on outcomes, concern about persistent inequalities and data black-outs.

Gonzalez-Espinoza L, Ortiz A - Clin Kidney J (2015)

Mean 2010–12 adjusted incidence and prevalence data for selected countries and regions. (A) Incidence of RRT, pmp at Day 1 standardized to the age and gender distribution of the EU27 population. (B) Incidence of RRT, pmarp at Day 1 for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. (C) Prevalence of RRT, pmp on 31 December, standardized to the age and gender distribution of the EU27 population. (D) Prevalence of RRT, pmarp on 31 December, for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. Note the difference in scale between whole population values (A and C) and over 75-year-old values (B and D). Data expressed as mean + SD of years 2010–12. Nd: no data, *unadjusted. Belgium-D: Belgium Dutch-speaking (Flanders), Belgium-F: Belgium French-speaking (Wallonia).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440478&req=5

SFV035F2: Mean 2010–12 adjusted incidence and prevalence data for selected countries and regions. (A) Incidence of RRT, pmp at Day 1 standardized to the age and gender distribution of the EU27 population. (B) Incidence of RRT, pmarp at Day 1 for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. (C) Prevalence of RRT, pmp on 31 December, standardized to the age and gender distribution of the EU27 population. (D) Prevalence of RRT, pmarp on 31 December, for those over 75 years of age. 2010–11 non-standardized 2012: standardized to the age and gender distribution of the EU27 population. Note the difference in scale between whole population values (A and C) and over 75-year-old values (B and D). Data expressed as mean + SD of years 2010–12. Nd: no data, *unadjusted. Belgium-D: Belgium Dutch-speaking (Flanders), Belgium-F: Belgium French-speaking (Wallonia).
Mentions: The recent publication of the 2012 ERA-EDTA Registry Annual Report contains both good news and bad news [1]. On the bright side, survival of patients on renal replacement therapy (RRT) for end-stage chronic kidney disease (CKD) is progressively increasing as observed when 2012 data are compared with 2011 and 2010 data [1–3] (Figure 1). On the dark side, the 2012 report shows persistence of inequalities in the incidence and prevalence of RRT and in access to optimal therapeutic modalities, such as kidney transplantation, across different European countries (Figures 2 and 3), that appear to be unexplained by demography or by per capita gross domestic product (Figure 4). Three countries, Greece, Belgium and Portugal, the GBP (pronounced GeeBeeP) countries, top the charts of incidence and prevalence of RRT one more year. These differences may point out serious issues with public health planning, access or provision of predialysis healthcare or access to RRT in Europe—although it is yet unclear whether the problem lies with the GBPs or the rest of Europe.Fig. 1.

Bottom Line: Living in Greece, Belgium (French- or Dutch-speaking) or Portugal (the GBP countries) is associated with higher chances of initiating RRT than living in other European countries.Unravelling the underlying reasons is an urgent research need: only an understanding of the causes will allow correction of the problem.Unavailability of data from some large countries (e.g. Germany and Italy) is not helpful.

View Article: PubMed Central - PubMed

Affiliation: IIS-Fundacion Jimenez Diaz, School of Medicine , Universidad Autonoma de Madrid , Madrid , Spain ; Fundacion Renal Iñigo Alvarez de Toledo-IRSIN and REDINREN , Madrid , Spain.

ABSTRACT
The 2012 ERA-EDTA Registry Annual Report contains both good news and bad news. On the bright side, the 2-year survival of patients starting renal replacement therapy (RRT) for chronic kidney disease (CKD), on dialysis or receiving a living-related kidney transplantation, has progressively increased to 82.2, 79.7 and 98.3%, respectively, whereas for cadaveric kidney transplantation it remains stable (96.0-96.1%). On the dark side, inequalities persist between European citizens in access to renal transplantation and in incidence and prevalence of RRT. Living in Greece, Belgium (French- or Dutch-speaking) or Portugal (the GBP countries) is associated with higher chances of initiating RRT than living in other European countries. The adjusted RRT incidence for GBP countries was 188, 201-174 and 220* (* unadjusted) pmp in 2012, respectively (versus 122, 114 and 97 pmp in the Netherlands or two Spanish regions bordering Portugal). In lower income countries, a low RRT incidence may represent lack of access to needed healthcare (e.g. Montenegro 26 pmp). However, how can the high incidence and prevalence of RRT in the GBP countries be explained? Do GBP citizens have access to RRT that is denied, rejected or considered unnecessary in other high income countries? Does the GBP healthcare system fail to prevent progression of CKD? Do local genetic or environmental factors favour CKD progression? Unravelling the underlying reasons is an urgent research need: only an understanding of the causes will allow correction of the problem. Unavailability of data from some large countries (e.g. Germany and Italy) is not helpful.

No MeSH data available.


Related in: MedlinePlus