title: [Chronic kidney disease and kidney transplantation].
abstract: OBJECTIVE
  To report epidemiology and characteristics of end-stage renal disease (ESRD) patients and renal transplant candidates, and to evaluate access to waiting list and results of renal transplantation.
  
  
  METHODS
  An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords: "chronic kidney disease, epidemiology, kidney transplantation, cost, survival, graft, brain death, cardiac arrest, access, allocation". French legal documents have been reviewed using the government portal (http://www.legifrance.gouv.fr). Articles were selected according to methods, language of publication and relevance. The reference lists were used to identify additional historical studies of interest. Both prospective and retrospective series, in French and English, as well as review articles and recommendations were selected. In addition, French national transplant and health agencies (http://www.agence-biomedecine.fr and http://www.has-sante.fr) databases were screened using identical keywords. A total of 3234 articles, 6 official reports and 3 newspaper articles were identified; after careful selection 99 publications were eligible for our review.
  
  
  RESULTS
  The increasing prevalence of chronic kidney disease (CKD) leads to worsen organ shortage. Renal transplantation remains the best treatment option for ESRD, providing recipients with an increased survival and quality of life, at lower costs than other renal replacement therapies. The never-ending lengthening of the waiting list raises issues regarding treatment strategies and candidates' selection, and underlines the limits of organ sharing without additional source of kidneys available for transplantation.
  
  
  CONCLUSIONS
  Allocation policies aim to reduce medical or geographical disparities regarding enrollment on a waiting list or access to an allotransplant.
authors.affiliation: Service d'urologie et transplantation rénale, CHU de Montpellier, 34090 Montpellier, France; Université de Montpellier, 34090 Montpellier, France. Electronic address: r-thuret@chu-montpellier.fr.
authors.forename: R
authors.initials: R
authors.lastname: Thuret
authors.affiliation: Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France.
authors.forename: M O
authors.initials: MO
authors.lastname: Timsit
authors.affiliation: Service d'urologie et transplantation rénale, CHRU de Besançon, 25030 Besançon, France; Université de Franche-Comté, 25030 Besançon, France; Inserm UMR 1098, 25030 Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Kleinclauss
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D014850:Waiting Lists
keywords: Access; Accès; Allocation; Allocations; Brain death; Cardiac arrest; Chronic kidney disease; Cost; Coût; Epidemiology; Graft; Insuffisance rénale chronique; Kidney transplantation; Mort cérébrale; Survie; Survival; Transplant; Transplantation rénale; Épidémiologie