[Epidemiology of terminal renal insufficiency treated by dialysis and therapeutic options in a population of 400,000 inhabitants (1975-1986)].
Since January, 1, 1976, epidemiologic study of renal diseases has been leading in a French rural area of 400,000 inhabitants located in north coast of Britanny. Annual incidence of end stage renal failure (ESRF) treated by dialysis increased of 25% when two consecutive periods of five years each were compared: A (1976-1980) 46 per 10(6) inhabitants, B (1981-1985) 62 per 10(6) inhabitants. In 1986, the progression was confirmed: 96 per 10(6). At the time of the beginning of dialysis treatment, mean age (+/- SD) was not different between two periods: 53 +/- 17 yrs (A) vs 51 +/- 17 yrs (B) but it increased in 1986: 61 +/- 14 yrs. Sex ratio (M/F) progressed from 1 (A) to 1.75 (B). The study of causes of ESRF showed a net increase of secondary renal diseases (diabetes, amyloidosis), interstitial nephropathies due to obstructive uropathy (lithiasis) and drugs. For the period B, 91% of primary glomerulonephritis reaching ESRF had had renal biopsy. Idiopathic IgA nephropathy was the first cause of ESRF (13.7%, 0.85 pts/100,000) before diabetes (12%, 0.75/100,000), Polycystic disease (11.3%, 0.70/100,000), reflux nephropathy (9.6%, 0.60/100,000), focal and segmental glomerulosclerosis (8.8%, 055/100,000). Prevalence of ESRF for primary glomerulonephritis was calculated to 20.6% and according to the histological type to 28.3% for idiopathic IgA nephropathy, 34.8% for local and segmental glomerulosclerosis, 40% for idiopathic crescentic glomerulonephritis and only 6.6% for membraneous nephropathy. In the studied area, 58% of patients were treated out of hospital (at home or in self-dialysis units) whose 46% by hemodialysis and 12% by CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)
Simon
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Service de Néphrologie, CH La Beauchée, Saint-Brieuc.
Ang
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KS
Cam
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Ramée
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MP
D000293:Adolescent; D000328:Adult; D000368:Aged; D005602:France; D006437:Hemodialysis, Home; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D016030:Kidney Transplantation; D008875:Middle Aged; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012424:Rural Population
Epidémiologie de l'insuffisance rénale terminale traitée par dialyse et options thérapeutiques dans une population de 400,000 habitants (1975-1986).