Renal replacement therapy in Europe-a summary of the 2010 ERA-EDTA Registry Annual Report

Abstract

Background: This study provides a summary of the 2010 European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report (available at www.era-edta-reg.org).

Methods: This report includes data on renal replacement therapy (RRT) using data from the national and regional renal registries in 29 countries in Europe and bordering the Mediterranean Sea. Individual patient data were received from 27 registries, whereas 18 registries contributed data in aggregated form. We present incidence and prevalence of RRT, transplant rates, survival probabilities and expected remaining lifetimes. The latter two are solely based on individual patient records.

Results: In 2010, the overall incidence rate of RRT for end-stage renal disease (ESRD) among all registries reporting to the ERA-EDTA Registry was 123 per million population (pmp) (n = 91 798). The highest incidence rate was reported by Turkey (252pmp) and the lowest reported by Montenegro (21 pmp). The overall prevalence of RRT for ESRD at 31 December 2010 among all registries reporting to the ERA-EDTA Registry was 741 pmp (n = 551 005). The prevalence varied from 124 pmp in Ukraine to 1580 pmp in Portugal. The overall number of renal transplantations performed in 2010 among all registries was 29.2 pmp (n = 21 740). The highest overall transplant rate was reported from Spain, Cantabria (73 pmp), whereas the highest transplant rate for living donor kidneys was reported from the Netherlands (28 pmp). For patients who started RRT between 2001 and 2005, the unadjusted 5-year patient survival on RRT was 46.2% [95% confidence interval (CI) 46.0-46.3], and on dialysis 38.6% (95% CI 38.5-38.8). The unadjusted 5-year patient survival after the first renal transplantation performed between 2001 and 2005 was 86.6% (95% CI 86.1-87.1) for deceased donor kidneys and 94.1% (95% CI 93.4-94.8) for living donor kidneys.

Fig. 1.

Incidence of RRT pmp at Day 1, 2010 among all national and regional renal registries in 29 countries reporting to the ERA-EDTA Registry in 2010. B&H, Bosnia–Herzegovina; FYROM, Former Yugoslav Republic of Macedonia; ME, Montenegro. The incidence data for the Czech Republic, Italy, Slovakia and Turkey include dialysis patients only.

Fig. 2.

Incidence of RRT pmp at Day 1 in 2010, unadjusted and standardized to the age and gender distribution of the EU27 population, and the mean and median age (years) at RRT initiation. Figures include data from renal registries providing individual patient data (left figure) and aggregated data (right figure). The aggregated data from the Czech Republic, Italy, Slovakia and Turkey include dialysis patients only.

Fig. 3.

Prevalence of RRT pmp at 31 December 2010, unadjusted and standardized to the age and gender distribution of the EU27 population, and the mean and median age (years). Figures include data from renal registries providing individual patient data (left figure) and aggregated data (right figure). The aggregated data from Israel, Italy and Slovakia include dialysis patients only. In Italy, the prevalence of RRT is underestimated by ∼11%, due to an estimated 25–30% under-reporting of patients living on a functioning graft, and in Romania, the prevalence of RRT is underestimated by ∼3%, due to an estimated 30% under-reporting of patients living on a functioning graft.

Fig. 4.

Renal transplants performed pmp in 2010, by donor type, unadjusted. Figures include data from renal registries providing individual patient data (left figure) and aggregated data (right figure). For Romania, the transplantation activity reflects 70% of the total transplantation activity in the country, because there is an under-reporting of pre-emptive transplantations. We used data from NHS Blood and Transplant Service, Centro Nazionale Trapianti, the Slovak Centre of Organ Transplantation and the Organización Nacional de Trasplantes (ONT) for UK, Italy (14 of 20 regions), Slovakia and Spain (18 of 19 regions), respectively.