[Using Dialysis and Transplantation Registries for regional and small-area epidemiology].
BACKGROUND
Aim of this review on Italian Dialysis and Transplantation Registries (RDTR), mostly of recent implementation, is to assess the use of epidemiological data for planning purposes, in order to promote local developments of regional registries. METHODS; Medline and reports on the website of the Italian Society of Nephrology.


RESULTS
We selected two publications with data from the Italian Registry (RIDT) and 56 articles on RDTR. Most papers refer to RDTR for the Italian regions of Piedmont, Lombardy and Lazio. RIDT reports containing 1998-1999 data for all the regions are published on web. Consistent with international figures, epidemiological data show an increasing incidence and prevalence of end-stage renal disease patients on renal replacement therapy (RRT), particularly older patients with diabetes and vascular diseases. Important regional variations are observed (RIDT data): 1995-97 dialysis provision (3-25 centres pmp; private: 2%-83%) - 1999 frequency figures: RRT incidence (75-200 pmp); dialysis prevalence (437-842 pmp), transplant prevalence (21-344 pmp) - 1995 mortality (8%-15%). Data on referral modalities and access to RRT seem scarce. Some studies assess hospital use among dialysis patients, while no papers have been found on the decision-making processes in local planning and policy.


CONCLUSIONS
RDTR are still under-utilised for developing local data, both for further investigating epidemiological and clinical differences, and for guiding decisions in regions with different resources and cultural background. We believe that linking RDTR data with other regional databases represents an effective strategy.
Laboratorio di Epidemiologia e Politiche Sanitarie, Dipartimento di Farmacologia Clinica ed Epidemiologia, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Italy. vitullo@negrisud.it
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Vitullo
D015706:Bibliometrics; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003661:Decision Support Techniques; D003920:Diabetes Mellitus / Q000453:epidemiology; D004812:Epidemiologic Methods; D006285:Health Planning; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000706:statistics & numerical data; D017582:Renal Replacement Therapy