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Review
. 2024 Dec 12;18(2):sfae405.
doi: 10.1093/ckj/sfae405. eCollection 2025 Feb.

The ERA Registry Annual Report 2022: Epidemiology of Kidney Replacement Therapy in Europe, with a focus on sex comparisons

Rianne Boenink  1   2 , Marjolein Bonthuis  1   3 , Brittany A Boerstra  1   2 , Megan E Astley  1   3 , Iris R Montez de Sousa  1   2 , Jaakko Helve  4   5 , Kirill S Komissarov  6 , Jordi Comas  7 , Danilo Radunovic  8 , Lukas Buchwinkler  9 , Kristine Hommel  10 , Nikola Gjorgjievski  11   12 , Ana A Galvão  13 , Nicos Mitsides  14   15   16 , Maria Marques Vidas  17   18 , Alicja M Dębska-Ślizień  19 , Csaba Ambrus  20   21 , Maria F Slon-Roblero  22 , Marc A G J Ten Dam  23 , Mathilde Lassalle  24 , Rebecca Guidotti  25 , Inmaculada Marín Sánchez  26 , Viktorija Kuzema  27   28 , Sara Trujillo Alemán  29 , Edita Ziginskiene  30   31 , Shalini Santhakumaran  32 , Maria O Valentin  33 , Antonio Sarrión Auñón  34 , Olafur S Indridason  35 , Nurhan Seyahi  36 , Marta Artamendi Larrañaga  37 , Milica Kravljaca  38   39 , Adrián Okša  40 , Héctor García López  41 , Anders Åsberg  42 , Ivan Rychlik  43 , Mai Ots-Rosenberg  44   45 , Pazit Beckerman  46   47 , Vjollca Godanci-Kelmendi  48 , Maria Stendahl  49 , Joe Lakey  50 , Kitty J Jager  1   2 , Alberto Ortiz  51   52 , Anneke Kramer  1   2 , Vianda S Stel  1   2
Affiliations
Review

The ERA Registry Annual Report 2022: Epidemiology of Kidney Replacement Therapy in Europe, with a focus on sex comparisons

Rianne Boenink et al. Clin Kidney J. .

Erratum in

Abstract

The European Renal Association (ERA) Registry collects data on kidney replacement therapy (KRT) in patients with end-stage kidney disease (ESKD). This paper summarizes the ERA Registry Annual Report 2022, with a special focus on comparisons by sex. The supplement of this paper contains the complete ERA Registry Annual Report 2022. Data was collected from 53 national and regional KRT registries from 35 countries. Using this data, incidence, and prevalence of KRT, kidney transplantation rates, survival probabilities, and expected remaining lifetimes were calculated. In 2022, 530 million people of the European general population were covered by the ERA Registry. The incidence of KRT was 152 per million population (pmp). In incident patients, 54% were 65 years or older, 64% were male, and the most common primary renal disease (PRD) was diabetes mellitus (22%). At KRT initiation, 83% of patients received haemodialysis, 12% received peritoneal dialysis, and 5% underwent pre-emptive kidney transplantation. On 31 December 2022, the prevalence of KRT was 1074 pmp. In prevalent patients, 48% were 65 years or older, 62% were male, the most common PRD was of miscellaneous origin (18%), 56% of patients received haemodialysis, 5% received peritoneal dialysis, and 39% were living with a functioning graft. In 2022, the kidney transplantation rate was 40 pmp, with most kidneys coming from deceased donors (66%). For patients starting KRT between 2013 to 2017, 5-year survival probability was 52%. Compared with the general population, the expected remaining lifetime was 66% and 68% shorter for males and females, respectively, receiving dialysis, and 46% and 49% shorter for males and females, respectively, living with a functioning graft.

Keywords: ESKD; dialysis; graft survival; kidney transplantation; patient survival.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1:
Figure 1:
Incidence per million population (pmp) of KRT in 2022 on day 1 by country or region, unadjusted.
Figure 2:
Figure 2:
Incidence of KRT per million population in 2022 on day 1 by country or region, unadjusted (left panel), and adjusted (right panel). Registries providing individual patient data are shown as dark bars and registries providing aggregated data as light bars. Adjustment was performed by standardizing the incidence to the age and sex distribution of the EU27 population.
Figure 3:
Figure 3:
Distribution of (a) age, (b) sex, (c) PRD (1995 ERA codes), and (d) PRD (2012/2018 ERA codes), by type of data provided for incident patients accepted for KRT in 2022 on day 1, unadjusted. See Appendix 1 for a list of countries and regions providing individual patient or aggregated data. Panel (d) is only based on the data from registries providing individual patient data. Bars may not add up to 100% due to rounding.
Figure 4:
Figure 4:
Distribution of treatment modality by (a) type of data provided, (b) age, (c) sex, and (d) PRD (DM and non-DM) for incident patients accepted for KRT in 2022 on day 1, unadjusted. Panels (b)–(d) are only based on the data from registries providing individual patient data. See Appendix 1 for a list of countries and regions providing individual patient or aggregated data. Abbreviation: Tx: transplant.
Figure 5:
Figure 5:
Distribution of treatment modality by (a) type of data provided, (b) age, (c) sex, and (d) PRD (DM and non-DM) for incident patients accepted for KRT in 2022 on day 91, unadjusted. Panels (b)–(d) are only based on the data from registries providing individual patient data. See Appendix 1 for a list of countries and regions providing individual patient or aggregated data. Turkey and Spain (aggregated data) did not provide data for day 91. Bars may not add up to 100% due to rounding. Abbreviation: Tx: transplant.
Figure 6:
Figure 6:
Prevalence per million population (pmp) of KRT on 31 December 2022 by country or region, unadjusted.
Figure 7:
Figure 7:
Prevalence per million population of KRT on 31 December 2022 by country or region, unadjusted (left panel) and adjusted (right panel). Registries providing individual patient data are shown as dark bars and registries providing aggregated data as light bars. Adjustment was performed by standardizing the prevalence to the age and sex distribution of the EU27 population.
Figure 8:
Figure 8:
Distribution of (a) age, (b) sex, and (c) PRD (1995 ERA codes) by type of data provided for prevalent patients on KRT on 31 December 2022, unadjusted. See Appendix 1 for a list of countries and regions providing individual patient or aggregated data. Bars may not add up to 100% due to rounding.
Figure 9:
Figure 9:
Distribution of treatment modality by (a) type of data provided, (b) age, (c) sex, and (d) PRD (DM and non-DM) for prevalent patients on KRT on 31 December 2022, unadjusted. Panels (b)–(d) are only based on the data from registries providing individual patient data. See Appendix 1 for a list of countries and regions providing individual patient or aggregated data. Bars may not add up to 100% due to rounding. Abbreviation: Tx: transplant.
Figure 10:
Figure 10:
Kidney transplantations performed in 2022 counts (N) and per million population by country or region, unadjusted. Registries providing individual patient data are shown as red bars and registries providing aggregated data as orange bars.
Figure 11:
Figure 11:
Kidney transplantations performed in 2022 per million population by donor type and by country or region, unadjusted. Registries providing individual patient data are shown as dark bars and registries providing aggregated data as light bars.
Figure 12:
Figure 12:
Donor type distribution for kidney transplantations performed in 2022 by type of data provided, unadjusted. See Appendix 1 for a list of countries and regions providing individual patient or aggregated data.
Figure 13:
Figure 13:
Patient survival by modality (haemodialysis or peritoneal dialysis) for incident dialysis patients accepted for KRT in 2022 on day 91 (cohort 2013–2017), unadjusted. See Appendix 2 for a list of countries and regions providing individual patient data included in the survival analyses.
Figure 14:
Figure 14:
Patient survival in first-time kidney transplant recipients by donor type (deceased or living) from day of transplant (cohort 2013–2017), unadjusted. See Appendix 2 for a list of countries and regions providing individual patient data included in the survival analyses.
Figure 15:
Figure 15:
Expected remaining years of life in the general population and for prevalent dialysis and kidney transplant patients (cohort 2018–2022), by sex. See Appendix 2 for a list of countries and regions providing individual patient data included in the expected remaining years of life analyses.
Figure 16:
Figure 16:
Incidence of KRT per million population (pmp) in 2022 on day 1 by sex, unadjusted.
Figure 17:
Figure 17:
Percentage of female incident patients accepted for KRT in 2022 on day 1 by country or region, unadjusted.
Figure 18:
Figure 18:
Distribution of (a) age, (b) PRD (1995 ERA codes), and (c) PRD (2012/2018 ERA codes), and (d) treatment modality by sex for incident patients accepted for KRT in 2022 on day 1, unadjusted. This figure is only based on data from registries providing individual patient data (see Appendix 1). Bars may not add up to 100% due to rounding. Abbreviation: Tx: transplantation.
Figure 19:
Figure 19:
Prevalence of KRT per million population (pmp) on 31 December 2022 by sex, unadjusted.
Figure 20:
Figure 20:
Percentage of female prevalent patients on KRT on 31 December 2022, unadjusted.
Figure 21:
Figure 21:
Distribution of (a) age, (b) PRD (1995 ERA codes), and (c) treatment modality by sex for prevalent patients on KRT on 31 December 2022, unadjusted. This figure is only based on data from registries providing individual patient data (see Appendix 1). Bars may not add up to 100% due to rounding. Abbreviation: Tx: transplantation.
Figure 22:
Figure 22:
Kidney transplants per million population (pmp) by sex, unadjusted.
Figure 23:
Figure 23:
Donor type distribution by sex in kidney transplant recipients. Bars may not add up to 100% due to rounding.
Figure 24:
Figure 24:
Patient survival in incident dialysis patients by sex from day 91 (cohort 2013–2017), unadjusted. See Appendix 2 for a list of countries and regions providing individual patient data included in the survival analyses.
Figure 25:
Figure 25:
Patient survival in first-time kidney transplant recipients by sex from day of transplant (cohort 2013–2017), unadjusted. See Appendix 2 for a list of countries and regions providing individual patient data included in the survival analyses.
See this image and copyright information in PMC

References

    1. Boerstra BA, Boenink R, Astley MEet al. The ERA Registry Annual Report 2021: A summary. Clin Kidney J 2024;17:sfad281. 10.1093/ckj/sfad281 - DOI - PMC - PubMed
    1. Eurostat: www.ec.europa.eu/eurostat/data/database (October 2023, date last accessed).