title: The Prevalence of Renal Failure. Results from the German Health Interview and Examination Survey for Adults, 2008-2011 (DEGS1).
abstract: BACKGROUND
  The prevalence of non-end stage renal failure among adults in Germany is unknown. Accurate figures would enable us to estimate the overall need for kidney replacement therapies and the unexploited potential for disease prevention. Renal failure is also an important cardiovascular risk factor. Until now, American prevalence figures have often been applied to Germany despite dissimilarities between the two populations.
  
  
  METHODS
  We analyzed data on renal function from the nationwide German Health Interview and Examination Survey for Adults, 2008-2011 (DEGS1), which was carried out by the Robert Koch Institute. The glomerular filtration rate was estimated (eGFR) from the serum creatinine and cystatin C levels (CKD-EPI formula) and a semiquantitative measure of albuminuria. Relationships between renal failure and its possible determinants were quantified with adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI).
  
  
  RESULTS
  Roughly 2.3% (95% CI: [1.9; 2.6 ]) of persons aged 18-79 had an eGFR below 60 mL/min/1.73 m2. The prevalence rose with age. We extrapolated these figures conservatively to persons aged 80 and above, who were not included in the DEGS1, and arrived at a figure of at least 2 million persons in Germany with renal failure. 11.5% of the population have albuminuria of at least 30 mg/L. Diabetes mellitus (PR = 2.25, 95% CI: [1.59; 3.16]) and arterial hypertension (PR = 3.46, 95% CI: [1.95; 6.12]) are important determinants.
  
  
  CONCLUSIONS
  This study provides the first representative estimate of the prevalence of renal failure in Germany. The condition is highly dependent on age but less prevalent than previously assumed on the basis of American prevalence figures.
authors.affiliation: Department of Medicine II, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Institute for Medical Epidemiology, Biometrics and Computer Science, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin, Center for Clinical Epidemiology; Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Department of Epidemiology, School of Public Health, Boston University, Boston, USA.
authors.forename: Matthias
authors.initials: M
authors.lastname: Girndt
authors.forename: Pietro
authors.initials: P
authors.lastname: Trocchi
authors.forename: Christa
authors.initials: C
authors.lastname: Scheidt-Nave
authors.forename: Silke
authors.initials: S
authors.lastname: Markau
authors.forename: Andreas
authors.initials: A
authors.lastname: Stang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology*; D004522:Educational Status; D004651:Employment; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007182:Income; D007677:Kidney Function Tests / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers