Nephrol Dial Transplant (2001) 16: 1120-1129
© 2001 European Renal Association-European Dialysis and Transplant Association
Registry Report
Renal replacement therapy in Europe: the results of a collaborative effort by the ERA–EDTA registry and six national or regional registries
1 ERA–EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam; 2 Dutch End-Stage Renal Disease Registry (RENINE), Erasmus University Hospital, Rotterdam, The Netherlands; 3 French–Belgian Nephrologists Registry, Centre Hospitalier Etterbeek-Ixelles, Brussels, Belgium; 4 Leiden University Medical Centre, Department of Clinical Epidemiology, Leiden, The Netherlands; 5 Finnish Kidney Disease Registry and Department of Medicine, Helsinki University Hospital, Helsinki, Finland; 6 Austrian Dialysis and Transplant Registry (OEDTR), General Hospital of Wels, Wels, Austria; 7 Norwegian Renal Registry, Institute of Immunology, Rikshospitalet University Hospital, Oslo, Norway; 8 Scottish Renal Registry, Glasgow Royal Infirmary, Glasgow, UK
Abstract
Background. In June 2000 a new ERA–EDTA Registry Office was opened in Amsterdam. This Registry will only collect core data on renal replacement therapy (RRT) through national and regional registries. This paper reports the technical and epidemiological results of a pilot study combining the data from six registries.
Methods. Data from the national renal registries of Austria, Finland, French-Belgium, The Netherlands, Norway, and Scotland were combined. Patients starting RRT between 1980 and 1999 (n=57371) were included in the analyses. Cox proportional hazards regression was used to predict survival.
Results. The use of different coding systems for ESRD treatment by the registries made it difficult to merge the data. Incidence and prevalence of RRT showed a continuous increase with a marked variation in rates between countries. The 2-, 5- and 10-year patient survival was 67, 35 and 11% in dialysis patients and 90, 81 and 64% after a first renal allograft. Multivariate analysis showed a slightly better survival on dialysis in the 1990–1994 (RR 0.94, 95% CI 0.90–0.98) and the 1995–1999 cohort (RR 0.88, 95% CI 0.84–0.92) compared to the 1980–1984 cohort. In contrast, there was a much greater improvement in transplant-patient survival, resulting in a 56% reduction in the risk of death within the 1995–1999 cohort (RR 0.44, 95% CI 0.39–0.50) compared to the 1980–1984 cohort.
Conclusions. This study provides support for the feasibility of a ‘new style’ ERA–EDTA registry and the collection of data is now being extended to other countries. The improvement in patient survival over the last two decades has been much greater in transplant recipients than in dialysis patients.
Keywords: epidemiology; Europe; mortality; primary renal disease; renal replacement therapy; technique survival
Notes
Correspondence and offprint requests to: Kitty J. Jager MD PhD, ERA–EDTA Registry, Academic Medical Center, University of Amsterdam, Department of Medical Informatics, J.2–254, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
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