International comparison of trends in patients commencing renal replacement therapy by primary renal disease

Nephrology (Carlton). 2019 Oct;24(10):1064-1076. doi: 10.1111/nep.13531. Epub 2019 Apr 29.

Abstract

Aim: To examine international time trends in the incidence of renal replacement therapy (RRT) for end-stage renal disease (ESRD) by primary renal disease (PRD).

Methods: Renal registries reporting on patients starting RRT per million population for ESRD by PRD from 2005 to 2014, were identified by internet search and literature review. The average annual percentage change (AAPC) with a 95% confidence interval (CI) of the time trends was computed using Joinpoint regression.

Results: There was a significant decrease in the incidence of RRT for ESRD due to diabetes mellitus (DM) in Europe (AAPC = -0.9; 95%CI -1.3; -0.5) and to hypertension/renal vascular disease (HT/RVD) in Australia (AAPC = -1.8; 95%CI -3.3; -0.3), Canada (AAPC = -2.9; 95%CI -4.4; -1.5) and Europe (AAPC = -1.1; 95%CI -2.1; -0.0). A decrease or stabilization was observed for glomerulonephritis in all regions and for autosomal dominant polycystic kidney disease (ADPKD) in all regions except for Malaysia and the Republic of Korea. An increase of 5.2-16.3% was observed for DM, HT/RVD and ADPKD in Malaysia and the Republic of Korea.

Conclusion: Large international differences exist in the trends in incidence of RRT by primary renal disease. Mapping of these international trends is the first step in defining the causes and successful preventative measures of CKD.

Keywords: diabetes mellitus; hypertension; primary renal disease; renal replacement therapy; trends; worldwide.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Diabetic Nephropathies / complications*
  • Diabetic Nephropathies / epidemiology
  • Female
  • Global Health / trends
  • Glomerulonephritis / complications*
  • Glomerulonephritis / epidemiology
  • Humans
  • Incidence
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / etiology
  • Kidney Failure, Chronic* / therapy
  • Male
  • Middle Aged
  • Polycystic Kidney, Autosomal Dominant / complications*
  • Polycystic Kidney, Autosomal Dominant / epidemiology
  • Preventive Health Services
  • Public Health / trends
  • Renal Replacement Therapy / methods
  • Renal Replacement Therapy / statistics & numerical data*
  • Risk Factors
  • Vascular Diseases / complications*
  • Vascular Diseases / epidemiology