Buzzi Marie, Couchoud Cécile, Crémades Adeline, Devictor Bénédicte, Moranne Olivier, Ayav Carole
Inserm, CIC 1433 épidémiologie clinique, délégation à la recherche clinique et a l'innovation, CHRU de Nancy, université de Lorraine, hôpitaux de Brabois, allée du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France.
Agence de la biomédecine, coordination nationale REIN, La Plaine-Saint-Denis, France.
Nephrol Ther. 2021 Oct;17(6):415-421. doi: 10.1016/j.nephro.2021.02.004. Epub 2021 May 24.
Since 2001, the aim of the REIN registry has been to identify patients suffering from end-stage renal disease and benefiting from replacement therapy in France. The analysis of trajectories aims to evaluate the flow of patients between the different types of treatment in order to better understand and predict patient pathways. The objective of this study was to analyse the incoming and outgoing flows at 1 year of patients prevalent in the REIN registry on 12/31/2017.
Flow analysis was carried out on patients prevalent on 12/31/2017 in the REIN registry by studying the before and after treatment modalities on 12/31/2016 and 12/31/2018. This analysis was initially carried out on all patients, then in sub-groups for each of the 5 treatment modalities.
The analyses covered 85,472 patients prevalent on 12/31/2017. The overall analysis showed that more than 20% of patients had been diagnosed with end-stage renal disease the year before. Regarding inflow, there was a relative stability for patients treated with self-care hemodialysis, in-center haemodialysis, peritoneal dialysis, and graft, in contrast to patients treated with hemodialysis in a medical unit. Regarding outgoing flows, proportion of deaths at one year was 9%. Peritoneal dialysis was the modality with the highest outflow proportion at one year.
Analysis of patients' trajectories shows variable evolution profiles according to treatment modality and thus could be a valuable tool in the evaluation and improvement of management and care in the field of end-stage renal disease.
自2001年以来，法国终末期肾病登记系统（REIN registry）的目标是识别终末期肾病患者并使其受益于替代疗法。轨迹分析旨在评估不同治疗类型之间的患者流动情况，以便更好地理解和预测患者路径。本研究的目的是分析2017年12月31日REIN登记系统中现存患者在1年时的流入和流出情况。
通过研究2016年12月31日和2018年12月31日的治疗方式前后情况，对2017年12月31日REIN登记系统中现存的患者进行流动分析。该分析最初对所有患者进行，然后针对5种治疗方式中的每一种进行亚组分析。
分析涵盖了2017年12月31日的85472名现存患者。总体分析表明，超过20%的患者在前一年被诊断为终末期肾病。关于流入情况，自我护理血液透析、中心血液透析、腹膜透析和移植治疗的患者相对稳定，而在医疗单位接受血液透析治疗的患者则不然。关于流出情况，1年时的死亡比例为9%。腹膜透析是1年时流出比例最高的治疗方式。
患者轨迹分析显示，根据治疗方式不同，其演变情况各异，因此可能是评估和改善终末期肾病领域管理与护理的宝贵工具。
