Background
Methods
Type of study
Data sources
Study population and period of analysis
Data collected
Analyzed data
Data analysis
Results
Trends of initial RRT (dialysis or with a pre-emptive renal transplant) since 2004
2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
All new patients starting RRT | 664 | 739 | 737 | 762 | 808 | 837 | 832 | 912 | 889 | 913 | 951 | 1011 |
Pre-emptive transplant, n (%) | 7 (1.1) | 5 (0.7) | 6 (0.8) | 15 (2.0) | 24 (3.0) | 11 (1.3) | 21 (2.5) | 22 (2.4) | 21 (2.4) | 35 (3.8) | 37 (3.9) | 29 (2.9) |
Initial dialysis, n (%) | 657 (98.9) | 734 (99.3) | 731 (99.2) | 747 (98.0) | 784 (97.0) | 826 (98.7) | 811 (97.5) | 890 (97.6) | 868 (97.6) | 878 (96.2) | 914 (96.1) | 982 (97.1) |
Characteristics of the new patients starting their first dialysisa | ||||||||||||
Age Mean ± SDb | 68.5 ± 15.7 | 67.9 ± 15.5 | 68.4 ± 15.5 | 68.1 ± 15.8 | 70.0 ± 14.7 | 68.3 ± 16.8 | 70.6 ± 15.1 | 70.7 ± 15.3 | 71.1 ± 15.4 | 70.3 ± 14.6 | 70.9 ± 14.8 | 70.1 ± 16.5 |
< 20 years, n (%) | 9 (1.4) | 4 (0.5) | 7 (1.0) | 9 (1.2) | 7 (0.9) | 15 (1.8) | 10 (1.2) | 10 (1.1) | 6 (0.7) | 6 (0.7) | 2 (0.2) | 14 (1.4) |
≥ 80 years, n (%) | 160 (24.4) | 154 (21.0) | 167 (22.8) | 172 (23.0) | 214 (27.3) | 241 (29.2) | 246 (30.3) | 278 (31.2) | 287 (33.1) | 255 (29.0) | 295 (32.3) | 315 (32.1) |
Gender: Male, n (%) | 416 (63.3) | 448 (61.0) | 460 (62.9) | 484 (64.8) | 474 (60.5) | 554 (67.1) | 527 (65.0) | 566 (63.7) | 587 (67.6) | 586 (66.7) | 589 (64.4) | 644 (65.6) |
Residing outside the region PACA, n (%) | 15 (2.3) | 20 (2.7) | 15 (2.1) | 13 (1.7) | 18 (2.3) | 26 (3.1) | 16 (2.0) | 22 (2.5) | 28 (3.2) | 13 (1.5) | 10 (1.1) | 15 (1.5) |
Comorbidities | ||||||||||||
MD
c
=4.2% (13.4–0.4)
| ||||||||||||
None | 151 (23.0) | 167 (22.8) | 178 (24.4) | 203 (27.2) | 190 (24.2) | 244 (29.5) | 200 (24.7) | 191 (21.5) | 206 (23.7) | 202 (23.0) | 171 (18.7) | 229 (23.3) |
Mean number ± SDa | 2.2 ± 1.3 | 2.1 ± 1.3 | 2.2 ± 1.4 | 2.1 ± 1.3 | 2.1 ± 1.2 | 2.3 ± 1.4 | 2.2 ± 1.3 | 2.5 ± 1.4 | 2.4 ± 1.4 | 2.5 ± 1.6 | 2.4 ± 1.5 | 2.4 ± 1.6 |
Diabetes, n (%) | 212 | 253 | 252 | 243 | 302 | 290 | 306 | 356 | 345 | 368 | 389 | 400 |
MD = 4.4% (10.6–0.2) | (37.2) | (39.8) | (35.9) | (36.1) | (40.3) | (35.3) | (38.1) | (40.4) | (40.0) | (42.2) | (42.9) | (41.0) |
At least one CVDd | 307 | 319 | 371 | 335 | 388 | 418 | 440 | 525 | 497 | 490 | 546 | 546 |
MD = 5.3% (14.3–1.1) | (54.5) | (50.6) | (52.9) | (50.5) | (52.2) | (51.7) | (56.0) | (60.1) | (57.9) | (56.5) | (60.5) | (56.9) |
Cancer | 37 | 60 | 68 | 53 | 65 | 59 | 77 | 86 | 106 | 102 | 100 | 112 |
MD = 4.9% (10.9–0.6) | (6.6) | (9.5) | (9.7) | (8.0) | (8.7) | (7.4) | (9.9) | (9.9) | (12.5) | (11.8) | (11.1) | (11.7) |
BMIe, n (%) | ||||||||||||
MD = 22.6% (57.4–2.7)
| ||||||||||||
Underweight (< 18.5) | 38 (7.9) | 39 (7.2) | 29 (5.6) | 37 (7.3) | 44 (7.7) | 39 (5.9) | 46 (6.7) | 58 (7.4) | 41 (5.4) | 37 (4.6) | 46 (5.5) | 38 (4.3) |
Normal (18.5–24.9) | 239 (49.7) | 273 (50.3) | 231 (44.6) | 259 (51.2) | 272 (47.5) | 315 (47.7) | 336 (48.8) | 363 (46.1) | 321 (41.9) | 344 (42.4) | 330 (39.1) | 366 (41.7) |
Overweight (25.0–29.9) | 149 (31.0) | 155 (28.5) | 175 (33.8) | 151 (29.8) | 177 (30.9) | 203 (30.7) | 182 (26.5) | 230 (29.2) | 257 (33.6) | 256 (31.5) | 259 (30.7) | 297 (33.8) |
Obese (≥ 30) | 55 (11.4) | 76 (14.0) | 83 (16.0) | 59 (11.7) | 80 (14.0) | 104 (15.7) | 124 (18.0) | 137 (17.4) | 147 (19.2) | 175 (21.6) | 209 (24.8) | 177 (20.2) |
Initial dialysis techniques and modalities, n (%) | ||||||||||||
DPf | 49 (7.5) | 58 (7.9) | 49 (6.7) | 46 (6.2) | 32 (4.1) | 50 (6.1) | 49 (6.0) | 59 (6.6) | 65 (7.5) | 71 (8.1) | 71 (7.8) | 81 (8.2) |
HDg | 608 (92.5) | 676 (92.1) | 682 (93.3) | 701 (93.8) | 752 (95.9) | 776 (93.9) | 762 (94.0) | 831 (93.4) | 803 (92.5) | 807 (91.9) | 843 (92.2) | 901 (91.8) |
In-center HD | 543 (89.3) | 608 (89.9) | 622 (91.2) | 622 (88.7) | 676 (89.9) | 691 (89.0) | 694 (91.1) | 729 (87.7) | 745 (92.8) | 729 (90.3) | 777 (92.2) | 816 (90.6) |
HD in medical satellite unit | – | 1 (0.1) | 4 (0.6) | 10 (1.4) | 11 (1.5) | 15 (1.9) | 18 (2.4) | 32 (3.9) | 25 (3.1) | 38 (4.7) | 38 (4.5) | 47 (50.2) |
HD in self-care unit | 54 (8.9) | 54 (8.0) | 40 (5.9) | 51 (7.3) | 43 (5.7) | 41 (5.3) | 33 (4.3) | 33 (4.0) | 13 (1.6) | 22 (2.7) | 22 (2.6) | 28 (3.1) |
HD at home | 11 (1.8) | 13 (1.9) | 15 (2.2) | 18 (2.6) | 22 (2.9) | 29 (3.7) | 17 (2.2) | 37 (4.5) | 20 (2.5) | 18 (2.2) | 6 (0.7) | 10 (1.1) |
β (95% CI) | Exp(β) (95% CI) |
p
| |
---|---|---|---|
New patients starting RRT | 0.033 (0.027–0.039) | 1.034 (1.028–1.039) | < 0.001 |
Pre-emptive transplant | 0.145 (0.105–0.185) | 1.156 (1.111–1.203) | < 0.001 |
New patients starting their first dialysis | 0.031 (0.025–0.036) | 1.031 (1.025–1.037) | < 0.001 |
Age: 80 years and more | 0.066 (0.056–0.077) | 1.069 (1.057–1.080) | < 0.001 |
None co-morbidity | 0.019 (0.007–0.030) | 1.019 (1.007–1.031) | 0.002 |
At least one cardiovascular disease | 0.055 (0.047–0.063) | 1.057 (1.048–1.065) | < 0.001 |
Diabetes | 0.054 (0.045–0.064) | 1.056 (1.046–1.066) | < 0.001 |
Cancer | 0.082 (0.062–0.101) | 1.085 (1.064–1.106) | < 0.001 |
Underweight (< 18.5) | 0.016 (− 0.010–0.042) | 1.016 (0.990–1.043) | 0.220 |
Normal BMI (18.5–24.9) | 0.038 (0.029–0.048) | 1.039 (1.029–1.049) | < 0.001 |
Overweight (25.0–29.9) | 0.065 (0.053–0.076) | 1.067 (1.055–1.079) | < 0.001 |
Obese (≥ 30) | 0.116 (0.100–0.132) | 1.123 (1.105–1.141) | < 0.001 |
DP | 0.050 (0.028–0.071) | 1.051 (1.028–1.074) | < 0.001 |
HD | 0.029 (0.023–0.035) | 1.030 (1.023–1.036) | < 0.001 |
In-center HD | 0.031 (0.025–0.037) | 1.031 (1.025–1.038) | < 0.001 |
HD in medical satellite unit | 0.245 (0.201–0.290) | 1.278 (1.222–1.336) | < 0.001 |
HD in self-care unit | − 0.092 (−0.120 − −0.063) | 0.913 (0.887–0.939) | < 0.001 |
Renal transplant performed | 0.050 (0.039–0.062) | 1.052 (1.039–1.064) | < 0.001 |
Living donor | 0.190 (0.140–0.241) | 1.210 (1.150–1.272) | < 0.001 |
Deceased donor | 0.041 (0.029–0.053) | 1.042 (1.029–1.055) | < 0.001 |
Patients receiving RRT | 0.036 (0.034–0.038) | 1.037 (1.034–1.039) | < 0.001 |
Patients with a functional renal transplant | 0.055 (0.051–0.059) | 1.057 (1.053–1.061) | < 0.001 |
Patints on dialysis | 0.026 (0.023–0.029) | 1.026 (1.024–1.029) | < 0.001 |
Age: 80 years and more | 0.105 (0.099–0.111) | 1.111 (1.104–1.118) | < 0.001 |
None co-morbidities | 0.006 (0.001–0.012) | 1.006 (1.001–1.012) | 0.027 |
Diabetes | 0.067 (0.062–0.072) | 1.070 (1.064–1.075) | < 0.001 |
Cancer | 0.105 (0.094–0.116) | 1.111 (1.099–1.123) | < 0.001 |
At least one CVD | 0.059 (0.055–0.063) | 1.061 (1.057–1.065) | < 0.001 |
Underweight (< 18.5) | 0.053 (0.041–0.066) | 1.055 (1.041–1.069) | < 0.001 |
Normal BMI (18.5–24.9) | 0.076 (0.071–0.081) | 1.079 (1.074–1.084) | < 0.001 |
Overweight (25.0–29.9) | 0.097 (0.091–0.103) | 1.102 (1.095–1.108) | < 0.001 |
Obese (≥ 30) | 0.131 (0.123–0.139) | 1.140 (1.131–1.149) | < 0.001 |
DP | 0.027 (0.014–0.040) | 1.027 (1.014–1.041) | < 0.001 |
HD | 0.027 (0.024–0.030) | 1.027 (1.024–1.030) | < 0.001 |
In-center HD | 0.019 (0.015–0.022) | 1.019 (1.015–1.022) | < 0.001 |
HD in medical satellite unit | 0.311 (0.299–0.324) | 1.365 (1.348–1.382) | < 0.001 |
HD in self-care unit | −0.035 (−0.041 − −0.028) | 0.966 (0.960–0.972) | < 0.001 |
HD at home | −0.159 (−0.182 − −0.136) | 0.853 (0.834–0.873) | < 0.001 |
Characteristics of new patients starting a treatment by dialysis, PACA, 2004–2015
Number of ESRD patients treated by dialysis or living with a renal transplant in the PACA region at the 31st December between 2004 and 2015
2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
ESRD patients treated on December 31 | ||||||||||||
All ESRD | 4433 | 4542 | 4716 | 4908 | 5081 | 5312 | 5517 | 5729 | 5920 | 6101 | 6357 | 6475 |
Living with a renal transplant, n (%) | 1361 (30.7) | 1406 (31.0) | 1500 (31.8) | 1599 (32.6) | 1713 (33.7) | 1802 (33.9) | 1918 (34.8) | 2032 (35.5) | 2116 (35.7) | 2237 (36.7) | 2349 (37.0) | 2456 (37.9) |
On dialysis, n (%) | 3072 (69.3) | 3136 (69.0) | 3216 (68.2) | 3309 (67.4) | 3368 (66.3) | 3510 (66.1) | 3599 (65.2) | 3697 (64.5) | 3804 (64.3) | 3864 (63.3) | 4008 (63.0) | 4019 (62.1) |
Characteristics of patients treated by dialysis on December 31a | ||||||||||||
Age mean ± SDb | 64.9 ± 15,4 | 65.0 ± 15,3 | 65.6 ± 15,0 | 66.1 ± 14,9 | 66.9 ± 14,6 | 67.1 ± 14,7 | 67.5 ± 15,0 | 69,4 ± 15,0 | 69.3 ± 15,2 | 69.6 ± 14,9 | 69.8 ± 14,9 | 70,1 ± 15,1 |
< 20 years, % | 24 (0.8) | 20 (0.6) | 11 (0.3) | 16 (0.5) | 11 (0.3) | 13 (0.4) | 19 (0.5) | 16 (0.4) | 20 (0.5) | 14 (0.4) | 14 (0.3) | 24 (0.6) |
≥ 80 years, % | 453 (14.7) | 466 (14.9) | 481 (15.0) | 531 (16.0) | 622 (18.5) | 672 (19.1) | 754 (21.0) | 1008 (27.3) | 1053 (27.7) | 1087 (28.1) | 1181 (29.5) | 1254 (31.2) |
Gender: male, n (%) | 1843 (60,0) | 1887 (60,2) | 1949 (60,6) | 2011 (60,8) | 2035 (60,4) | 2151 (61,3) | 2202 (61,2) | 2275 (61,5) | 2371 (62,3) | 2431 (62,9) | 2500 (62,4) | 2567 (63.9) |
Residing outside the PACA region, n (%) | 102 (3.3) | 102 (3.3) | 88 (2.7) | 92 (2.8) | 91 (2.7) | 101 (2.9) | 92 (2.6) | 89 (2.4) | 95 (2.5) | 93 (2.4) | 101 (2.5) | 100 (2.5) |
Comorbidities | ||||||||||||
MD
c
=4.6% (10.4–0.2)
| ||||||||||||
None, % | 753 (24.5) | 791 (25.2) | 824 (25.6) | 889 (26.9) | 899 (26.7) | 990 (28.2) | 980 (27.2) | 821 (22.2) | 866 (22.8) | 874 (22.6) | 836 (20.9) | 858 (21,3) |
Mean number ± SD | 2,3 ± 1,4 | 2,2 ± 1,3 | 2,1 ± 1,3 | 2,1 ± 1,3 | 2,1 ± 1,3 | 2,1 ± 1,3 | 2,2 ± 1,4 | 2,4 ± 1,4 | 2,5 ± 1,4 | 2,5 ± 1,5 | 2,5 ± 1,5 | 2,5 ± 1,5 |
Main comorbidities, n (%) | ||||||||||||
Diabetes | 782 | 837 | 918 | 933 | 1022 | 1103 | 1174 | 1290 | 1369 | 1446 | 1563 | 1597 |
MD = 4.4% (10.6–0.2) | (28.3) | (29.8) | (31.3) | (30.7) | (32.2) | (32.8) | (33.5) | (35.2) | (36.1) | (37.5) | (39.1) | (39.0) |
At least one CVDd | 1514 | 1485 | 1504 | 1530 | 1632 | 1685 | 1814 | 2235 | 2312 | 2335 | 2488 | 2559 |
MD = 4.7% (10.8–0.4) | (54.8) | (53.1) | (51.3) | (50.6) | (51.6) | (50.3) | (52.2) | (60.9) | (61.1) | (60.6) | (62.4) | (62.7) |
Cancer | 144 | 147 | 163 | 177 | 192 | 199 | 237 | 296 | 322 | 352 | 373 | 408 |
MD = 4.9% (10.9–0.6)
| (5.2) | (5.3) | (5.6) | (5.9) | (6.1) | (6.0) | (6.9) | (8.1) | (8.5) | (9.2) | (9.4) | (10.0) |
BMIe in kg/m2, % | ||||||||||||
MD = 22.6% (57.4 in 2004--2.7)
| ||||||||||||
Underweight (< 18.5) | 104 (8.0) | 135 (7.7) | 136 (7.1) | 139 (6.6) | 155 (6.6) | 155 (5.8) | 169 (5.8) | 202 (5.8) | 192 (5.4) | 193 (5.2) | 201 (5.3) | 204 (5.2) |
Normal (18.5–24.9) | 654 (50.5) | 867 (49.8) | 915 (47.4) | 1030 (48.7) | 1144 (48.5) | 1298 (48.5) | 1444 (49.4) | 1657 (47.9) | 1675 (46.7) | 1644 (44.7) | 1623 (42.5) | 1666 (42.7) |
Overweight (25.0–29.9) | 385 (29.7) | 506 (29.0) | 590 (30.6) | 645 (30.5) | 718 (30.4) | 818 (30.6) | 851 (29.1) | 1045 (30.2) | 1117 (31.1) | 1148 (31.2) | 1224 (32.0) | 1251 (32.1) |
Obese (≥ 30) | 11.7 | 13.4 | 14.9 | 14.2 | 14.5 | 15.1 | 15.8 | 16.0 | 16.8 | 18.8 | 20.2 | 20.0 |
Current dialysis modalities, % | ||||||||||||
DPf | 149 (4,9) | 158 (5,0) | 146 (4,5) | 140 (4,2) | 120 (3,6) | 126 (3,6) | 136 (3,8) | 152 (4,1) | 161 (4,2) | 173 (4,5) | 187 (4,7) | 196 (4,9) |
HDg | 2923 (95,1) | 2978 (95,0) | 3070 (95,5) | 3169 (95,8) | 3248 (96,4) | 3384 (96,4) | 3463 (96,2) | 3545 (95,9) | 3643 (95,8) | 3691 (95,5) | 3821 (95,3) | 3913 (97.4) |
In-center HD | 2093 (71,6) | 2126 (71,4) | 2228 (72,6) | 2309 (72,9) | 2335 (71,9) | 2381 (70,4) | 2437 (70,4) | 2449 (69,1) | 2483 (68,2) | 2484 (67,3) | 2566 (67,2) | 2603 (66,5) |
HD in medical satellite unit | 1 (0.003) | 3 (0,1) | 9 (0,3) | 39 (1,2) | 79 (2,4) | 194 (5,7) | 314 (9,1) | 441 (12,4) | 552 (15,2) | 625 (16,9) | 706 (18,5) | 755 (19,3) |
HD in self-care unit | 672 (23,0) | 745 (25,0) | 737 (24,0) | 752 (23,7) | 779 (24,0) | 760 (22,5) | 673 (19,4) | 619 (17,5) | 567 (15,6) | 539 (14,6) | 522 (13,7) | 525 (13,4) |
HD at home | 157 (5,4) | 104 (3,5) | 96 (3,1) | 69 (2,2) | 55 (1,7) | 49 (1,4) | 39 (1,1) | 36 (1,0) | 41 (1,1) | 43 (1,2) | 27 (0,7) | 30 (0,8) |
Number of renal transplants performed in the PACA region: Trends since 2004
2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of renal transplants performed | 159 | 123 | 169 | 160 | 205 | 167 | 221 | 209 | 208 | 246 | 243 | 239 |
Donor type, n (%) | ||||||||||||
Deceased donor | 159 (100,0) | 123 (99,2) | 169 (93,5) | 160 (95,0) | 205 (92,2) | 167 (95,8) | 221 (96,4) | 209 (94,3) | 208 (90,4) | 246 (89,8) | 243 (88,9) | 239 (88,7) |
Living donor | – | 1 (0,8) | 11 (6,5) | 8 (5,0) | 16 (7,8) | 7 (4,2) | 8 (3,6) | 12 (5,7) | 20 (9,6) | 25 (10,1) | 27 (11,1) | 27 (11,3) |