title: Trends in the incidence of renal replacement therapy for end-stage renal disease in Europe, 1990-1999.
abstract: BACKGROUND
  The epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) varies considerably worldwide, but we have lacked reliable quantitative estimates of trends in the incidence by age, sex and cause in Europe over the last decade.
  
  
  METHODS
  We analysed data from nine countries participating in the ERA-EDTA registry: Austria, Belgium, Denmark, Finland, Greece, The Netherlands, Norway, Spain and UK (Scotland). Adjusted incidence rates for age and sex were studied for 2 year periods between 1990 and 1999. Average annual changes (%) were estimated by Poisson regression.
  
  
  RESULTS
  The adjusted incidence rate of RRT increased from 79.4 per million population (pmp) (range: 58.4-101.0) in 1990-1991 to 117.1 pmp (91.6-144.8) in 1998-1999, i.e. 4.8% (3.1-6.4%) each year. This increase did not flatten out at the end of the decade, except in The Netherlands, and was greater in men than women, 5.2 vs 4.0%/year. In most countries, the incidence rate remained stable for those younger than 45 years; it rose by 2.2%/year on average in the 45-64 year age group and by 7.0% among those 65-74 years; it tripled over the decade in those 75 years or older, and by 1998-1999 it ranged from 140.9 to 540.4 pmp between countries. The incidence of ESRD due to diabetes, hypertension and renal vascular disease nearly doubled over 10 years; in 1998-1999, it varied between countries from 10.2 to 39.3 pmp for diabetes, from 5.8 to 21.0 for hypertension, and from 1.0 to 15.5 for renal vascular disease.
  
  
  CONCLUSIONS
  RRT incidence continues to rise but at various rates in the European countries studied, tending to widen the gap between them. This mainly results from enlarging differences in incidence in the elderly and, to a lesser extent, in that due to diabetes, hypertension and renal vascular disease.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale, INSERM Unité 258, Villejuif, France. stengel@vjf.inserm.fr
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Stengel
authors.forename: Solenne
authors.initials: S
authors.lastname: Billon
authors.forename: Paul C W
authors.initials: PC
authors.lastname: Van Dijk
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.forename: Keith
authors.initials: K
authors.lastname: Simpson
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Briggs
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D017582:Renal Replacement Therapy / Q000639:trends*; D012737:Sex Factors