补充后的 ERA-EDTA 登记数据评估了欧洲肾衰竭患者接受透析、肾移植和综合保守治疗的频率。

Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe.

机构信息

European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

出版信息

Kidney Int. 2021 Jul;100(1):182-195. doi: 10.1016/j.kint.2020.12.010. Epub 2021 Jan 7.

DOI:10.1016/j.kint.2020.12.010

PMID:33359055

Abstract

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of replacement therapy for kidney failure was 132 per million population (pmp), varying from 29 (Ukraine) to 251 pmp (Greece). On 31 December 2016, the overall prevalence of kidney replacement therapy was 985 pmp, ranging from 188 (Ukraine) to 1906 pmp (Portugal). The prevalence of peritoneal dialysis (114 pmp) and home hemodialysis (28 pmp) was highest in Cyprus and Denmark respectively. The kidney transplantation rate was nearly zero in some countries and highest in Spain (64 pmp). In 28 countries with five or more responding nephrologists, the median percentage of candidates for kidney replacement therapy who were offered CCM in 2018 varied between none (Slovakia and Slovenia) and 20% (Finland) whereas the median prevalence of CCM varied between none (Slovenia) and 15% (Hungary). Thus, the substantial differences across Europe in the frequency of kidney replacement therapy and CCM indicate the need for improvement in access to various treatment options for patients with kidney failure.

摘要

本研究旨在确定欧洲肾衰竭患者进行透析和肾移植的频率，并评估综合保守管理（CCM）的规律性。本研究使用了 ERA-EDTA 注册中心的数据。此外，我们的研究还包括来自亚美尼亚、德国、匈牙利、爱尔兰、科索沃、卢森堡、马耳他、摩尔多瓦、黑山、斯洛文尼亚的数据，以及来自以色列、意大利、斯洛伐克的其他信息来源的数据。通过在线调查，参与调查的肾病学家估计了 33 个国家 CCM（即计划进行整体护理而非肾脏替代治疗）的频率。2016 年，肾衰竭替代治疗的总发病率为每百万人口 132 例（pmp），范围从 29 例（乌克兰）到 251 pmp（希腊）。截至 2016 年 12 月 31 日，肾脏替代治疗的总患病率为 985 pmp，范围从 188 例（乌克兰）到 1906 pmp（葡萄牙）。腹膜透析（114 pmp）和家庭血液透析（28 pmp）的患病率在塞浦路斯和丹麦最高。一些国家的肾移植率几乎为零，而西班牙的肾移植率最高（64 pmp）。在 28 个有 5 名或以上参与调查的肾病学家的国家中，2018 年接受肾脏替代治疗的候选人中接受 CCM 的中位数百分比在 0%（斯洛伐克和斯洛文尼亚）和 20%（芬兰）之间，而 CCM 的中位数患病率在 0%（斯洛文尼亚）和 15%（匈牙利）之间。因此，欧洲各国在肾脏替代治疗和 CCM 频率方面存在显著差异，这表明需要改善肾衰竭患者获得各种治疗选择的机会。