Department of Nephrology, Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, The Netherlands.
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands.
Nephrol Dial Transplant. 2017 Feb 1;32(2):348-355. doi: 10.1093/ndt/gfw392.
Upcoming KDIGO guidelines for the evaluation of living kidney donors are expected to move towards a personal risk-based evaluation of potential donors. We present the age and sex-specific lifetime risk of renal replacement therapy (RRT) for end-stage renal disease in 10 European countries.
We defined lifetime risk of RRT as the cumulative incidence of RRT up to age 90 years. We obtained RRT incidence rates per million population by 5-year age groups and sex using data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, and used these to estimate the cumulative incidence of RRT, adjusting for competing mortality risk.
Lifetime risk of RRT varied from 0.44% to 2.05% at age 20 years and from 0.17% to 1.59% at age 70 years across countries, and was twice as high in men as in women. Lifetime RRT risk decreased with age, ranging from an average of 0.77% to 0.44% in 20- to- 70-year-old women, and from 1.45% to 0.96% in 20- to- 70-year-old men. The lifetime risk of RRT increased slightly over the past decade, more so in men than in women. However, it appears to have stabilized or even decreased slightly in more recent years.
The lifetime risk of RRT decreased with age, was lower in women as compared with men of equal age and varied considerably throughout Europe. Given the substantial differences in lifetime risk of RRT between the USA and Europe, country-specific estimates should be used in the evaluation and communication of the risk of RRT for potential living kidney donors.
即将发布的 KDIGO 指南预计将针对活体肾脏捐献者的评估，朝着基于个人风险的潜在供体评估方向发展。我们展示了 10 个欧洲国家中年龄和性别特异性终末期肾病肾脏替代治疗（RRT）的终生风险。
我们将 RRT 的终生风险定义为 90 岁之前 RRT 的累积发生率。我们通过欧洲肾脏协会-欧洲透析与移植协会（ERA-EDTA）登记处获得每百万人口每 5 年年龄组和性别的 RRT 发病率数据，并使用这些数据来估计 RRT 的累积发生率，同时调整竞争死亡率风险。
在各国，20 岁时 RRT 的终生风险为 0.44%至 2.05%，70 岁时为 0.17%至 1.59%，男性是女性的两倍。终生 RRT 风险随年龄下降，20 至 70 岁女性的平均风险从 0.77%降至 0.44%，20 至 70 岁男性的风险从 1.45%降至 0.96%。在过去十年中，RRT 的终生风险略有增加，男性比女性更为明显。然而，近年来，它似乎已经稳定甚至略有下降。
RRT 的终生风险随年龄下降，女性低于同龄男性，并且在整个欧洲差异很大。鉴于美国和欧洲之间 RRT 的终生风险存在显著差异，应使用特定国家的估计值来评估和交流潜在活体肾脏捐献者的 RRT 风险。
