英国肾脏注册机构第11次年度报告(2008年12月):第4章 2007年英国终末期肾病患病率:全国及各中心具体分析

UK Renal Registry 11th Annual Report (December 2008): Chapter 4 ESRD prevalent rates in 2007 in the UK: national and centre-specific analyses.

作者信息

Farrington Ken, Hodsman Alex, Casula Anna, Ansell David, Feehally John

机构信息

Lister Hospital, Stevenage, UK.

出版信息

Nephron Clin Pract. 2009;111 Suppl 1:c43-68. doi: 10.1159/000209993. Epub 2009 Mar 26.

Abstract

INTRODUCTION

This chapter describes the demographics of UK RRT patients in 2007.

METHODS

Complete data were electronically collected from 71 UK centres with the remaining 1 centre submitting summary data. A series of cross-sectional and longitudinal analyses were performed to describe the demographics of prevalent UK RRT patients in 2007 at a centre and a national level.

RESULTS

There were 45,484 adult patients receiving RRT on 31/12/2007. The population prevalence for adults was 746 per million population per year (pmp) with an annual increase in prevalence of approximately 5% per annum. There was substantial variation in standardised prevalence ratios between Primary Care Trust (PCT)/Health Authority (HA) areas which were associated with geographical factors and differences in ethnicity with mean standardised prevalence ratios (SPR) significantly higher in PCTs/HAs with a high proportion of ethnic minorities. The median age of prevalent RRT patients was 57 years (HD 65 years, PD 60 years, transplant 50 years). Median RRT vintage was 5.3 years (HD 2.8 years, PD 2.1 years, transplant 10.4 years). For all ages, crude prevalence rates in males exceeded those in females, peaking in the 75-79 year age band for males at 2,506 pmp and in females in the 70-74 year age band at 1,314 pmp. The most common identifiable diagnosis was glomerulonephritis (15.3%) but in those over 65 it was diabetes (15.1%). The most common treatment modality was transplantation (46.6%), closely followed by centre-based HD (42.1%) in either the primary centre (25.2%) or the satellite unit (16.9%). The HD population has continued to expand, and the PD population to contract. HD was increasingly prominent with increasing age at the expense of transplantation.

CONCLUSIONS

There were national, area and dialysis centre level variation in the prevalent UK RRT population. This has implications for service planning and ensuring equity of care for RRT patients.

摘要

引言

本章描述了2007年英国接受肾脏替代治疗(RRT)患者的人口统计学特征。

方法

从71个英国中心以电子方式收集完整数据,其余1个中心提交汇总数据。进行了一系列横断面和纵向分析,以描述2007年英国中心和国家层面上接受RRT的现患患者的人口统计学特征。

结果

在2007年12月31日,有45484名成年患者接受RRT。成年人的总体患病率为每年每百万人口746例(pmp),患病率每年约增加5%。初级保健信托基金(PCT)/卫生局(HA)区域之间的标准化患病率比存在很大差异,这与地理因素以及种族差异有关,少数族裔比例高的PCTs/HAs的平均标准化患病率比(SPR)明显更高。接受RRT的现患患者的中位年龄为57岁(血液透析为65岁,腹膜透析为60岁,肾移植为50岁)。RRT的中位使用时间为5.3年(血液透析为2.8年,腹膜透析为2.1年,肾移植为10.4年)。在所有年龄段中,男性的粗患病率超过女性,男性在75 - 79岁年龄组达到峰值,为2506 pmp,女性在70 - 74岁年龄组达到峰值,为1314 pmp。最常见的可识别诊断是肾小球肾炎(15.3%),但在65岁以上人群中是糖尿病(15.1%)。最常见的治疗方式是肾移植(46.6%),其次是在主中心(25.2%)或卫星单位(16.9%)进行的基于中心的血液透析(42.1%)。血液透析人群持续扩大,腹膜透析人群持续减少。随着年龄增长,血液透析的比例越来越高,肾移植的比例则相应下降。

结论

英国接受RRT的现患人群在国家、地区和透析中心层面存在差异。这对服务规划以及确保RRT患者获得公平的医疗服务具有重要意义。

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