REIN registry, Biomedicine Agency, La Plaine-Saint Denis, France.
Nephrol Dial Transplant. 2010 May;25(5):1576-8. doi: 10.1093/ndt/gfp675. Epub 2010 Jan 6.
Variations in the timing of dialysis initiation may explain some geographical variations in renal replacement therapy (RRT) incidence, but this effect has never been quantified.
Using data from the French Renal Epidemiology and Information Network registry, we quantified the association between RRT incidence in 2006-07 and median estimated glomerular filtration rate (eGFR) values before starting dialysis at the administrative district level with geographically appropriate methods.
Crude RRT incidence varied from 80.4 to 238.6 pmi between administrative districts, and median eGFR at dialysis initiation from 5.9 to 11.8 ml/min/1.73 m(2). Age- and sex-adjusted RRT incidence, associated with a 1.2-ml/min/1.73m(2) increase in median eGFR, rose 8% (4-13%) before and 9% (5-13%) after controlling for the effect of nine potential socioeconomic and medical risk factors.
The impact of increased eGFR at initiation should be taken into account in guidelines recommending earlier dialysis start.
透析启动时间的变化可能解释了一些肾替代治疗（RRT）发生率的地理差异，但这种影响从未被量化过。
利用法国肾脏流行病学和信息网络登记处的数据，我们采用地理上适当的方法，在行政区域层面上，量化了 2006-07 年 RRT 发病率与开始透析前中位估算肾小球滤过率（eGFR）值之间的关系。
粗 RRT 发病率在行政区域之间从 80.4 到 238.6 pmi 不等，开始透析时的中位 eGFR 从 5.9 到 11.8 ml/min/1.73 m(2)。年龄和性别调整后的 RRT 发病率与中位 eGFR 增加 1.2 ml/min/1.73m(2)相关，在控制了九个潜在的社会经济和医疗风险因素的影响后，发病率分别上升了 8%（4-13%）和 9%（5-13%）。
在建议更早开始透析的指南中，应考虑起始时 eGFR 增加的影响。
