UK Renal Registry 11th Annual Report (December 2008): Chapter 4 ESRD prevalent rates in 2007 in the UK: national and centre-specific analyses

Abstract

Introduction: This chapter describes the demographics of UK RRT patients in 2007.

Methods: Complete data were electronically collected from 71 UK centres with the remaining 1 centre submitting summary data. A series of cross-sectional and longitudinal analyses were performed to describe the demographics of prevalent UK RRT patients in 2007 at a centre and a national level.

Results: There were 45,484 adult patients receiving RRT on 31/12/2007. The population prevalence for adults was 746 per million population per year (pmp) with an annual increase in prevalence of approximately 5% per annum. There was substantial variation in standardised prevalence ratios between Primary Care Trust (PCT)/Health Authority (HA) areas which were associated with geographical factors and differences in ethnicity with mean standardised prevalence ratios (SPR) significantly higher in PCTs/HAs with a high proportion of ethnic minorities. The median age of prevalent RRT patients was 57 years (HD 65 years, PD 60 years, transplant 50 years). Median RRT vintage was 5.3 years (HD 2.8 years, PD 2.1 years, transplant 10.4 years). For all ages, crude prevalence rates in males exceeded those in females, peaking in the 75-79 year age band for males at 2,506 pmp and in females in the 70-74 year age band at 1,314 pmp. The most common identifiable diagnosis was glomerulonephritis (15.3%) but in those over 65 it was diabetes (15.1%). The most common treatment modality was transplantation (46.6%), closely followed by centre-based HD (42.1%) in either the primary centre (25.2%) or the satellite unit (16.9%). The HD population has continued to expand, and the PD population to contract. HD was increasingly prominent with increasing age at the expense of transplantation.

Conclusions: There were national, area and dialysis centre level variation in the prevalent UK RRT population. This has implications for service planning and ensuring equity of care for RRT patients.