NDT Advance Access originally published online on September 27, 2005
Nephrology Dialysis Transplantation 2005 20(12):2803-2811; doi:10.1093/ndt/gfi099
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Prevalence of co-morbidity in different European RRT populations and its effect on access to renal transplantation
1 ERA–EDTA Registry, Academic Medical Center, University of Amsterdam, Department of Medical Informatics, Amsterdam, 2 Leiden University Medical Centre, Department of Clinical Epidemiology, Leiden, The Netherlands, 3 The UK Renal Registry, Southmead Hospital, Bristol, UK, 4 Registro Lombardo Dialisi e Trapianto, "Ospedale UBOLDO", Cernusco S/N, Milano, Italy, 5 Austrian Dialysis and Transplant Registry (OEDTR), General Hospital of Wels, Wels, Austria, 6 Norwegian Renal Registry, Institute of Immunology, Rikshospitalet University Hospital, Oslo, Norway and 7 Catalan Renal Registry (RMRC), Catalan Transplant Organisation, Catalan Health Service, Autonomous Government of Catalonia, Barcelona
Correspondence and offprint requests to: Vianda S. Stel, PhD, ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, J1b 113.1, PO Box 22700, 1100 DE Amsterdam, The Netherlands. Email: v.s.stel{at}amc.uva.nl
Background. This study compared the prevalence of co-morbidity in patients starting renal replacement therapy (RRT) between European countries and further examined how co-morbidity affects access to transplantation.
Methods. In this ERA-EDTA registry special study, 17907 patients from Austria, Catalonia (Spain), Lombardy (Italy), Norway, and the UK (England/Wales) were included (1994–2001). Co-morbidity was recorded at the start of RRT.
Results. The prevalence of co-morbidity was: diabetes mellitus (DM) (primary renal disease and co-morbidity) 28%, ischaemic heart disease (IHD) 23%, peripheral vascular disease (PVD) 24%, cerebrovascular disease (CVD) 14% and malignancy 11%. With exception of malignancy, the prevalence of co-morbidity was highest in Austria, but differences were small among other countries. With exception of DM, males suffered more often from co-morbidity than females. In general, the percentage of haemodialysis was higher in patients with co-morbidity, but treatment modality differed substantially between countries. Using a Cox regression with adjustment for demographics, country, year of start and other co-morbidities, the presence of each of the co-morbid conditions made it less likely [RR; 95%CI] to receive a transplant within 4 years: DM [0.79; 0.70–0.88], IHD [0.59; 0.50–0.70], PVD [0.57; 0.49–0.67], CVD [0.49; 0.39–0.61], and malignancy [0.32; 0.24–0.42]. The age, gender and year of start adjusted relative risk [95%CI] to receive a renal transplant within 4 years ranged from 0.23 [0.19–0.27] for Lombardy (Italy) to 3.86 [3.36–4.45] for Norway (Austria = reference). These international differences existed for patients with and without co-morbidity.
Conclusions. The prevalence of co-morbidity was highest in Austria but differences were small among other countries. The access to a renal graft was most affected by the presence of malignancy and least affected by the presence of DM. International differences in access to transplantation were only partly due to co-morbid variability.
Keywords: co-morbidity; dialysis; epidemiology; registries; renal replacement therapy; renal transplantation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. J. de Jager, D. C. Grootendorst, K. J. Jager, P. C. van Dijk, L. M. J. Tomas, D. Ansell, F. Collart, P. Finne, J. G. Heaf, J. De Meester, et al. Cardiovascular and Noncardiovascular Mortality Among Patients Starting Dialysis JAMA, October 28, 2009; 302(16): 1782 - 1789. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bayat, M. Kessler, S. Briancon, and L. Frimat Survival of transplanted and dialysed patients in a French region with focus on outcomes in the elderly Nephrol. Dial. Transplant., September 11, 2009; (2009) gfp469v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Morrone, S. Mazzaferro, D. Russo, F. Aucella, M. Cozzolino, M. G. Facchini, A. Galfre, F. Malberti, M. C. Mereu, M. Nordio, et al. Interaction between parathyroid hormone and the Charlson comorbidity index on survival of incident haemodialysis patients Nephrol. Dial. Transplant., September 1, 2009; 24(9): 2859 - 2865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Jager and C. Zoccali Comorbidity data collection by renal registries--a remaining challenge Nephrol. Dial. Transplant., August 1, 2009; 24(8): 2311 - 2313. [Full Text] [PDF]
|
|
|
|
|
|
G. Panzetta, C. Basile, A. Santoro, E. Ancarani, S. Costantini, F. Guarnieri, and G. Verzetti Diabetics on dialysis in Italy: a nationwide epidemiological study Nephrol. Dial. Transplant., December 1, 2008; 23(12): 3988 - 3995. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Caskey, R. Steenkamp, and D. Ansell International comparison of UK registry data (Chapter 17) Nephrol. Dial. Transplant., August 1, 2007; 22(suppl_7): vii185 - vii193. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Krediet 30 YEARS OF PERITONEAL DIALYSIS DEVELOPMENT: THE PAST AND THE FUTURE Perit. Dial. Int., June 1, 2007; 27(Supplement_2): S35 - S41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bayat, L. Frimat, N. Thilly, C. Loos, S. Briancon, and M. Kessler Medical and non-medical determinants of access to renal transplant waiting list in a French community-based network of care Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2900 - 2907. [Abstract] [Full Text] [PDF]
|
|