UK Renal Registry, Bristol, UK.
Nephron Clin Pract. 2012;120 Suppl 1:c105-35. doi: 10.1159/000342849. Epub 2012 Sep 1.
These analyses examine a) survival from the start of renal replacement therapy (RRT), based on the total incident UK RRT population reported to the UK Renal Registry, including the 18% who started on PD and the 7% who received a pre-emptive transplant and b) survival of prevalent patients. Changes in survival between 1997 and 2009 are also reported.
Survival of incident patients (starting RRT during 2009) was calculated both from the start of RRT and from 90 days after starting RRT, both with and without censoring at transplantation. Survival of prevalent dialysis patients was calculated to exclude patients once they were transplanted. Both Kaplan-Meier and Cox adjusted models were used to calculate survival. Causes of death were analysed for both groups. Relative risk of death was calculated compared with the general UK population.
The 2009 unadjusted 1 year after 90 day survival for patients starting RRT was 86.6% (87.3% in 2008). In incident patients aged 18-64, the unadjusted 1 year survival had increased from 86.0% in 1997 to 91.3% in 2009. In incident patients aged ≥ 65, unadjusted 1 year survival had improved from 64.1% to 76.2%. There were no survival differences between genders. The relative risk of death compared to the general population decreased from 25 times at age 30-34 to 2.7 times at age 85+. Cause of death data completeness has improved 18% since last year. Cardiac disease is the most common cause of death in prevalent dialysis patients and malignancy most frequent in prevalent transplant patients.
Survival of patients starting RRT has improved for all ages since 1997. The frequency of cardiac disease as the cause of death has decreased since 1997.
这些分析考察了 a）根据向英国肾脏注册处报告的英国全部新接受肾脏替代治疗（RRT）患者，包括 18%开始接受 PD 治疗和 7%接受预先移植的患者，从开始接受 RRT 时起的生存情况，以及 b）现患患者的生存情况。还报告了 1997 年至 2009 年期间生存情况的变化。
用 Kaplan-Meier 和 Cox 调整模型计算新发病例患者（2009 年开始接受 RRT）的生存情况，既包括从开始接受 RRT 起，也包括从开始接受 RRT 后 90 天起，两种情况均不包括在移植时进行的删失。在排除接受移植的患者后，计算现患透析患者的生存情况。对两组患者的死亡原因进行分析。与英国一般人群相比，计算死亡的相对风险。
2009 年，新发病例患者在开始接受 RRT 后 90 天的 1 年未调整生存率为 86.6%（2008 年为 87.3%）。在 18-64 岁的新发病例患者中，未经调整的 1 年生存率从 1997 年的 86.0%增加到 2009 年的 91.3%。在≥65 岁的新发病例患者中，未经调整的 1 年生存率从 64.1%提高到 76.2%。性别间无生存差异。与一般人群相比，30-34 岁时的死亡相对风险为 25 倍，85 岁及以上时降至 2.7 倍。自去年以来，死因数据的完整性提高了 18%。在现患透析患者中，心脏病是最常见的死亡原因，在现患移植患者中，恶性肿瘤是最常见的死亡原因。
自 1997 年以来，所有年龄段开始接受 RRT 的患者的生存率都有所提高。自 1997 年以来，心脏病作为死亡原因的频率有所下降。
