Nephrology Dialysis Transplantation, Vol 12, Issue 10 2117-2123, Copyright © 1997 by Oxford University Press
P Vestergaard and H Lokkegaard
Objectives: To predict the future prevalence of
patients on renal replacement therapy due to chronic renal failure in
Denmark.Subjects and methods: Four thousand and nine
terminal uraemic patients (median age 50.0 years, 15.2% diabetic) were
treated in Denmark with renal replacement therapy in the period 1 January
1991 to 31 December 1995. Incidence rates and rates of transition between
the treatment modalities (haemodialysis, peritoneal dialysis, and renal
transplantation) were calculated. The prediction was made using a Markov
model in three ways: (1) using the average rates (deterministic model), (2)
using rates simulated with pseudorandom numbers based on the average rates
(stochastic model), and (3) using increasing incidence rates in a
deterministic model. Results: Using present rates both
model types predicted a significant increase in the prevalence of renal
transplant recipients (<60 years (from 1003 in 1995 to about 1465 in
2006) and the prevalence of haemodialysis patients ⩾60 years (from
456 in 1995 to about 903 in 2006) while the prevalence of other treatment
modalities would change less dramatically. The overall prevalence
proportion would increase from 539 patients per million population (p.m.p.)
in 1995 to about 777 p.m.p. in 2006. The stochastic model clearly
demonstrated the uncertainties linked to the prognosis in contrast to the
deterministic model. The deterministic model with increasing rates
predicted a prevalence proportion of 1162 p.m.p. in 2006.
Conclusion: Even with present rates the prevalence of
haemodialysis patients in Denmark will continue to increase. Mathematical
models offers a good tool to study future trends and to plan future
capacity. Keywords: kidney failure; Markov model;
prognosis; renal replacement therapy
ORIGINAL ARTICLES
Predicting future trends in the number of patients on renal replacement therapy in Denmark
Danish National Registry, Danish Society of Nephrology; Corresponding author at: Afd.900, Aarhus Amtssygehus, Tage Hansens Gade 2, DK-8000 Aarhus C, Denmark
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