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[Access to the waiting list and renal transplantation].
- Source :
-
Nephrologie & therapeutique [Nephrol Ther] 2013 Sep; Vol. 9 Suppl 1, pp. S139-66. - Publication Year :
- 2013
-
Abstract
- This chapter provides a set of indicators related to Renal Transplantation access in France. It describes patient outcomes and reports on cumulative incidence rates of wait-listing and renal transplantation according to main patient of characteristics and regions. The REIN registry integrates kidney transplant and dialysis data. It provides a comprehensive view on waiting list and renal transplantation access to the patients, nephrologists, and national or regional health authorities. Access to the waiting list is evaluated on a cohort of 51,845 new patients who started dialysis between 2002 and 2011 in 25 regions. The probability of first wait-listing was of 3.7% at the start of dialysis (pre-emptive registrations), 15% at 12, 22% at 36 and 24% to 60 months. The probability of being registered was strongly related to age, diabetes and region. Patient older than 60 had a very poor access to the waiting list, whatever their diabetes status was. Probability of first wait-listing was much lower (36.5% at 60 months) in type 2 diabetic-40 to 59 years old patients. Among 13,653 patients less than 60 years old, the probability of being registered was 11% at the start of dialysis, 43% to 12 months, 62% to 36 months and 66% to 60 months (median dialysis duration: 16 months). Seventeen regions with up to 5 years follow-up show an increase of 8 to 15% in pre-emptive registrations between 2007 and 2001, without change at 1 year. Access to kidney transplant is evaluated on a cohort of 53,301 new patients who started a renal replacement therapy (dialysis or pre-emptive renal transplant) between 2002 and 2011 in 25 regions. The probability of first kidney transplant was of 7% at 12, 17% at 36 and 21% at 60 months. 8,633 patients (16,2%) had received a first renal transplant within 14.7 month median time; 1,455 (2.7%) had received a pre-emptive graft [male: 58%, median age: 48.7y]. Among the 14,770 new patients less than 60 years old, the probability of being transplanted was of 21% at 12, 46% at 36 and 58% at 60 months (median dialysis duration: 42 months). When pre-emptive graft were excluded, the probability of being transplanted was of 5% at 12, 15% to 36 and 19% to 60 months Insofar as kidney transplant is regarded as the most efficient treatment, access to the waiting list and renal transplant are sensitive issues.<br /> (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Cohort Studies
Diabetes Mellitus, Type 2 complications
Female
Follow-Up Studies
France epidemiology
Humans
Infant
Infant, Newborn
Kidney Failure, Chronic therapy
Male
Middle Aged
Registries
Risk Factors
Treatment Outcome
Kidney Failure, Chronic epidemiology
Kidney Failure, Chronic surgery
Kidney Transplantation statistics & numerical data
Waiting Lists
Subjects
Details
- Language :
- French
- ISSN :
- 1872-9177
- Volume :
- 9 Suppl 1
- Database :
- MEDLINE
- Journal :
- Nephrologie & therapeutique
- Publication Type :
- Academic Journal
- Accession number :
- 24119579
- Full Text :
- https://doi.org/10.1016/S1769-7255(13)70043-9