Renal replacement therapy for autosomal dominant polycystic kidney disease (ADPKD) in Europe: prevalence and survival--an analysis of data from the ERA-EDTA Registry
Open Access
- 27 August 2014
- journal article
- research article
- Published by Oxford University Press (OUP) in Nephrology Dialysis Transplantation
- Vol. 29 (suppl 4), iv15-iv25
- https://doi.org/10.1093/ndt/gfu017
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the fourth most common renal disease requiring renal replacement therapy (RRT). Still, there are few epidemiological data on the prevalence of, and survival on RRT for ADPKD. This study used data from the ERA-EDTA Registry on RRT prevalence and survival on RRT in 12 European countries with 208 million inhabitants. We studied four 5-year periods (1991–2010). Survival analysis was performed by the Kaplan–Meier method and by Cox proportional hazards regression. From the first to the last study period, the prevalence of RRT for ADPKD increased from 56.8 to 91.1 per million population (pmp). The percentage of prevalent RRT patients with ADPKD remained fairly stable at 9.8%. Two-year survival of ADPKD patients on RRT (adjusted for age, sex and country) increased significantly from 89.0 to 92.8%, and was higher than for non-ADPKD subjects. Improved survival was noted for all RRT modalities: haemodialysis [adjusted hazard ratio for mortality during the last versus first time period 0.75 (95% confidence interval 0.61–0.91), peritoneal dialysis 0.55 (0.38–0.80) and transplantation 0.52 (0.32–0.74)]. Cardiovascular mortality as a proportion of total mortality on RRT decreased more in ADPKD patients (from 53 to 29%), than in non-ADPKD patients (from 44 to 35%). Of note, the incidence rate of RRT for ADPKD remained relatively stable at 7.6 versus 8.3 pmp from the first to the last study period, which will be discussed in detail in a separate study. In ADPKD patients on RRT, survival has improved markedly, especially due to a decrease in cardiovascular mortality. This has led to a considerable increase in the number of ADPKD patients being treated with RRT.Keywords
This publication has 45 references indexed in Scilit:
- Prasugrel versus clopidogrel for patients with unstable angina or non-ST-segment elevation myocardial infarction with or without angiography: a secondary, prespecified analysis of the TRILOGY ACS trialThe Lancet, 2013
- Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney DiseaseNew England Journal of Medicine, 2012
- Use of Antihypertensive Medications and Mortality of Patients With Autosomal Dominant Polycystic Kidney Disease: A Population-Based StudyAmerican Journal of Kidney Diseases, 2011
- Global variation in renal replacement therapy for end-stage renal diseaseNephrology Dialysis Transplantation, 2011
- Improved Prognosis in Patients with Autosomal Dominant Polycystic Kidney Disease in DenmarkClinical Journal of the American Society of Nephrology, 2010
- Coût de la prise en charge de l’IRCT en France en 2007 et impact potentiel d’une augmentation du recours à la dialyse péritonéale et à la greffeNephrologie & Therapeutique, 2010
- An estimate of lifelong costs and QALYs in renal replacement therapy based on patients’ life expectancyHealth Policy, 2007
- Epidemiological study of kidney survival in autosomal dominant polycystic kidney diseaseKidney International, 2003
- Survival after end-stage renal disease in autosomal dominant polycystic kidney disease: Contribution of extrarenal complications to mortalityAmerican Journal of Kidney Diseases, 2001
- Autosomal dominant polycystic kidney disease in TorontoKidney International, 1993