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. 2010 May;25(5):1576-8.
doi: 10.1093/ndt/gfp675. Epub 2010 Jan 6.

The timing of dialysis initiation affects the incidence of renal replacement therapy

Cécile Couchoud  1 , Chantal Guihenneuc, Florian Bayer, Bénédicte Stengel; REIN Registry
Affiliations

The timing of dialysis initiation affects the incidence of renal replacement therapy

Cécile Couchoud et al. Nephrol Dial Transplant. 2010 May.

Abstract

Background: Variations in the timing of dialysis initiation may explain some geographical variations in renal replacement therapy (RRT) incidence, but this effect has never been quantified.

Methods: Using data from the French Renal Epidemiology and Information Network registry, we quantified the association between RRT incidence in 2006-07 and median estimated glomerular filtration rate (eGFR) values before starting dialysis at the administrative district level with geographically appropriate methods.

Results: Crude RRT incidence varied from 80.4 to 238.6 pmi between administrative districts, and median eGFR at dialysis initiation from 5.9 to 11.8 ml/min/1.73 m(2). Age- and sex-adjusted RRT incidence, associated with a 1.2-ml/min/1.73m(2) increase in median eGFR, rose 8% (4-13%) before and 9% (5-13%) after controlling for the effect of nine potential socioeconomic and medical risk factors.

Conclusion: The impact of increased eGFR at initiation should be taken into account in guidelines recommending earlier dialysis start.

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Figures

Figure 1
Figure 1
Geographical distribution of the crude RRT incidence by administrative districts
Figure 2
Figure 2
Geographical distribution of the median eGFR at dialysis initiation by administrative districts
See this image and copyright information in PMC

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