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  • van de Luijtgaarden, Moniek W. M.University of Amsterdam, Netherlands (author)

Trends in dialysis modality choice and related patient survival in the ERA-EDTA Registry over a 20-year period

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • 2015-08-26
  • OXFORD UNIV PRESS,2016
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-126862
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-126862URI
  • https://doi.org/10.1093/ndt/gfv295DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background. Although previous studies suggest similar patient survival for peritoneal dialysis (PD) and haemodialysis (HD), PD use has decreased worldwide. We aimed to study trends in the choice of first dialysis modality and relate these to variation in patient and technique survival and kidney transplant rates in Europe over the last 20 years. Methods. We used data from 196 076 patients within the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry who started renal replacement therapy (RRT) between 1993 and 2012. Trends in the incidence rate and prevalence on Day 91 after commencing RRT were quantified with Joinpoint regression. Crude and adjusted hazard ratios (HRs) for 5-year dialysis patient and technique survival were calculated using Cox regression. Analyses were repeated using propensity score matching to control for confounding by indication. Results. PD prevalence dropped since 2007 and HD prevalence stabilized since 2009. Incidence rates of PD and HD decreased from 2000 and 2009, respectively, while the incidence of kidney transplantation increased from 1993 onwards. Similar 5-year patient survival for PD versus HD patients was found in 1993-97 [adjusted HR: 1.02, 95% confidence interval (95% CI): 0.98-1.06], while survival was higher for PD patients in 2003-07 (HR: 0.91, 95% CI: 0.88-0.95). Both PD (HR: 0.95, 95% CI: 0.91-1.00) and HD technique survival (HR: 0.93, 95% CI: 0.87-0.99) improved in 2003-07 compared with 1993-97. Conclusions. Although initiating RRT on PD was associated with favourable patient survival when compared with starting on HD treatment, PD was often not selected as initial dialysis modality. Over time, we observed a significant decline in PD use and a stabilization inHD use. These observations were explained by the lower incidence rate of PD and HD and the increase in pre-emptive transplantation.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Jager, Kitty J.University of Amsterdam, Netherlands (author)
  • Segelmark, MårtenLinköpings universitet,Avdelningen för läkemedelsforskning,Medicinska fakulteten,Region Östergötland, Njurmedicinska kliniken US(Swepub:liu)marse71 (author)
  • Pascual, JulioHospital del Mar, Spain (author)
  • Collart, FredericFrench Speaking Belgium ESRD Registry, Belgium (author)
  • Hemke, Aline C.Nefrovisie RENINE, Netherlands (author)
  • Remon, CesarSICATA Informat Syst Andalusian Transplant Autono, Spain (author)
  • Metcalfe, WendyScottish Renal Registry, Scotland (author)
  • Miguel, AlfonsoUniversity of Clin Hospital, Spain (author)
  • Kramar, ReinhardOEDTR, Austria (author)
  • Aasarod, KnutSt Olavs Hospital HF, Norway (author)
  • Abu Hanna, AmeenUniversity of Amsterdam, Netherlands (author)
  • Krediet, Raymond T.University of Amsterdam, Netherlands (author)
  • Schon, StaffanDiaverum Renal Serv Grp, Sweden (author)
  • Ravani, PietroUniversity of Calgary, Canada (author)
  • Caskey, Fergus J.Southmead Hospital, England (author)
  • Couchoud, CecileBiomed Agency, France (author)
  • Palsson, RunolfurLandspitali National University Hospital Iceland, Iceland; University of Iceland, Iceland (author)
  • Wanner, ChristophUniversity of Amsterdam, Netherlands; University Hospital Wurzburg, Germany (author)
  • Finne, PatrikFinnish Registry Kidney Disease, Finland (author)
  • Noordzij, MarliesUniversity of Amsterdam, Netherlands (author)
  • University of Amsterdam, NetherlandsAvdelningen för läkemedelsforskning (creator_code:org_t)

Related titles

  • In:Nephrology, Dialysis and Transplantation: OXFORD UNIV PRESS31:1, s. 120-1280931-05091460-2385

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