Demography of dialysis and transplantation in Europe in 1985 and 1986: trends over the previous decade. Report from the European Dialysis and Transplant Association Registry.

The demography of renal replacement therapy for 1985 and 1986 is presented, based on returns of individual patient questionnaires to the EDTA Registry, supplemented by some data from the centre questionnaire. Patient questionnaires for 1985 were received from 83% of known centres and for 1986 from 79% of known centres in 33 countries. Of 244,497 individually registered patients, 116,892 were known to be alive on defined forms of renal replacement therapy on 31 December 1985 and 121,755 on 31 December 1986. Countries covered by the EDTA Registry include one-third of the world's population on renal replacement therapy. Individual countries exemplify different strategies with variable proportional contributions from home haemodialysis, CAPD and transplantation, and varying levels of achievement in numbers of patients on treatment. Trends in patient populations demonstrate that standard risk patients (aged under 55 and non-diabetic) are mostly receiving treatment in countries with advanced programmes, whereas the growth in numbers of new patients is due largely to increase in the acceptance of high-risk patients (aged over 55 or with diabetes mellitus). These trends have implications for the future; predictions must take account of the variable mixture of standard and high-risk patients, the different results achieved in these categories and the rates at which the mixture between them is changing.