Author(s): Couchoud C, Lassalle M, Stengel B, Jacquelinet C
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Abstract In 2007, 7197 patients with end-stage renal disease living in 18 regions ( Auvergne, Basse-Normandie, Bourgogne, Bretagne, Centre, Champagne-Ardenne, Corse, Haute-Normandie, Ile de France, Languedoc-Roussillon, Limousin, Lorraine, Midi-Pyrenees, Nord-Pas de Calais, Picardie, Poitou-Charentes, Provence-Alpes Cote d'Azur et Rhone-Alpes) covering 52 million inhabitants (82\% of the French population), started renal replacement therapy (dialysis or preemptive graft): median age was 70, 4 years; 3\% had preemptive graft. The overall crude annual incidence rate of renal replacement therapy for end-stage renal disease was 139 per million population(pmp), with significant differences in sex and age-adjusted incidence across regions (99 to 168 pmh). At initiation, more than one patient out of the two had at least one cardiovascular disease and 39\% diabetes (90\% Type 2 non-insulin-dependent diabetes). On December 31, 2007, 31056 patients living in 20 regions( the above region plus Aquitaine and la Reunion) were on dialysis: median age was 69, 8 years. On December 31, 2007, 25699 patients were living with a functioning graft: median age was 53,5 years. In these 20 regions, the overall prevalence of dialysis was 554 pmp, that of renal graft, 459 pmp and the overall rate of renal replacement therapy for end stage renal disease, 1013 pmp with significant differences in age-adjusted prevalence across regions (746 to 2,586 pmh). In the 2003-2007 cohort of 26423 incident patients, the overall one-year survival rate was 83\%, 56\% at 4 years. Survival decreased with age, but remains above 50\% at 2 years in patients older than 75 at RRT initiation. Among the 7195 new patients starting dialysis in 2007 in 19 regions, 7\% had a BMI lower than 18,5 kg/m2 and 18\% a BMI higher than 30. At initiation, 62\% had an haemoglobin value lower than 11 g/l and 10\% an albumin value lower than 25 g/l. The first haemodialysis was started in emergency in 32\% of the patients and with a catheter in 51\%. On December 31, 2007, 8\% treated in the dialysis units of the 20 regions received peritoneal dialysis, of which 39\% were treated with automated peritoneal dialysis. 95\% of the patients on haemodialysis had 3 sessions per week, with a median duration of 4 hours. In the 2002-2007 cohort of incident patients in 11 regions under 60 years, the probability to be at least once on the waiting list for a renal graft is 50\% at 18 months. In 2007, 2530 patients received renal graft. On December 31, 2007, 5661 patients were on the waiting list for a renal graft in the transplantation centres of the 20 regions..
This article was published in Nephrol Ther
and referenced in Evidence based Medicine and Practice