title: Regional differences in renal replacement therapy in northern Norway 2000-2012.
abstract: OBJECTIVE
  Distance from residence location to a centre for renal replacement therapy (RRT) may influence patients' quality of life and prognosis. Northern Norway constitutes 45% of Norway's landmass, but has less than 10% of the population.
  
  
  METHODS
  In this study, we analysed all patients in northern Norway consecutively registered in the Norwegian Renal Registry during 2000-2012. A total of 634 patients (Nordland County 321 patients, Troms County 215 patients and Finnmark County 98 patients) were investigated.
  
  
  RESULTS
  There were more smokers (31% vs. 22%) and patients with diabetes (32% vs. 22%) in Finnmark, but the difference did not reach statistical significance. Patients undergoing RRT and living in Finnmark County had a significantly worse outcome (P=0.03). The median survivals after initiation of RRT were 3.8 years (Finnmark), 6.4 years (Troms) and 5.4 years (Nordland), respectively. The most common causes of death were cardiovascular disease (53%), infections (16%), withdrawal from therapy (15%) and malignancy (13%). In a Cox analysis, age (P<0.0001), diabetes (P=0.008) and smoking at any time (P<0.004) were individual factors correlated with inferior prognosis.
  
  
  CONCLUSIONS
  Age, smoking and diabetes were prognostic factors. Residents of the northernmost county (Finnmark) experienced an inferior prognosis. Long distance from residence location to hospital may be another factor, but this could not be documented. Preventive strategies should be improved.
authors: Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.|Department of Radiology, University Hospital of North Norway (UNN), Tromsø, Norway; jan.norum@unn.no.
authors: Jan
authors: J
authors: Norum
authors: Norwegian Renal Registry, Section of Nephrology, Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors: Torbjørn
authors: T
authors: Leivestad
authors: Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.|Section of Nephrology, University Hospital of North Norway, Tromsø, Norway.
authors: Bjørn Odvar
authors: BO
authors: Eriksen
authors: Northern Norway Regional Health Authority Trust, Bodø, Norway.
authors: Siw
authors: S
authors: Skår
authors: Nordland Hospital, Bodø, Norway.
authors: Anne
authors: A
authors: Fagerheim
authors: Norwegian Renal Registry, Section of Nephrology, Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors: Anna Varberg
authors: AV
authors: Reisæter
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002423:Cause of Death; D003081:Cold Climate; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005843:Geography; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009664:Norway; D016016:Proportional Hazards Models; D012042:Registries; D017582:Renal Replacement Therapy / Q000401:mortality* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016019:Survival Analysis
keywords: Norway; renal replacement therapy; subarctic; survival