Department of Nephrology and Hypertension, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussels, Belgium.
Department of Nephrology, Universitair Ziekenhuis Antwerpen, Antwerpen, Belgium.
PLoS One. 2020 Jun 25;15(6):e0235004. doi: 10.1371/journal.pone.0235004. eCollection 2020.
A growing number of patients started renal replacement therapy (RRT) in Western industrialized countries between 1980 an early 2000s. Thereafter reports from national and international registries suggest a trend towards stabilization and sometimes a decrease in the incidence rate.
To investigate the differences in overall and age-specific incidence rates between industrialized countries from 1998 until 2013. Secondly, to investigate changes in incidence rates over time and their association with specific age categories.
We extracted the unadjusted overall incidence of RRT and age-specific incidence rates from renal registry reports in Europe, the United States, Canada, Australia and New Zealand. Time trends in the incidence rate by country and age categories were analyzed by Joinpoint regression analysis.
The incidence rate in 2013 ranged from 89 per million population (pmp) in Finland to 363 pmp in the US. Incidence rates in the lower age categories (20-64 year) were similar between countries and remained stable over time. Higher incidence countries were characterized by higher numbers of patients in both the 65-74 and ≥75 year categories starting RRT. Joinpoint analysis confirmed that most countries had significant reductions in the incidence rate at the end of the study period. These reductions were explained by lower numbers of older patients starting RRT and were observed also in countries with lower overall incidence rates.
This study confirmed different incidence rates of RRT between industrialized countries worldwide. Countries with the highest overall incidence rates also had the highest incidence rates in the oldest age categories. Since the early 2000's the number of older patients starting RRT is either stabilizing or even decreasing in most countries. This reduction is universal and is also observed in countries with previously low incidence rates.
20 世纪 80 年代至本世纪初，越来越多的患者在西方国家开始接受肾脏替代治疗（RRT）。此后，来自国家和国际登记处的报告表明，发病率呈稳定趋势，有时甚至下降。
调查 1998 年至 2013 年期间工业化国家总体和特定年龄组发病率的差异。其次，调查发病率随时间的变化及其与特定年龄组的关系。
我们从欧洲、美国、加拿大、澳大利亚和新西兰的肾脏登记报告中提取未经调整的 RRT 总发病率和特定年龄组的发病率。通过 Joinpoint 回归分析，分析了按国家和年龄组划分的发病率随时间的变化趋势。
2013 年的发病率范围为芬兰的 89/百万人口（pmp）至美国的 363 pmp。较低年龄组（20-64 岁）的发病率在各国之间相似，且随时间保持稳定。发病率较高的国家的特点是在 65-74 岁和≥75 岁两个年龄段开始接受 RRT 的患者人数较多。Joinpoint 分析证实，大多数国家在研究期末发病率显著下降。这些减少归因于开始接受 RRT 的老年患者人数减少，而且在总体发病率较低的国家也观察到了这种减少。
本研究证实了全球工业化国家 RRT 发病率的差异。总体发病率最高的国家在最年长的年龄组中也有最高的发病率。自 21 世纪初以来，大多数国家开始接受 RRT 的老年患者人数要么稳定，要么甚至减少。这种减少是普遍的，而且在以前发病率较低的国家也观察到了这种减少。
