[REIN annual report 2005. Renal Epidemiology and Information Network & Agence de la biomédecine]

In 2005, 6,021 patients with end-stage renal disease living in fourteen regions covering 45 millions inhabitants (73% of the French population), started renal replacement therapy (dialysis or preemptive graft): median age was 70 years; 3% had a preemptive graft. The overall crude annual incidence rate of renal replacement therapy for end-stage renal disease was 139 per million population (pmp) in thirteen regions that met exhaustivity, with significant differences in sex and age-adjusted incidence across regions (92 to 171 pmh). At initiation, 48% of the patients had at least one cardiovascular disease and 36% diabetes (89% Type 2 non-insulin-dependent diabetes). On December 31, 2005, 21,813 patients living in these fourteen regions were on dialysis: median age was 69 years. The overall crude prevalence rate of dialysis was 539 pmp in thirteen regions. On December 31, 2005, 19,491 patients were living with a functioning graft : median age was 53 years. The overall crude prevalence rate for these patients was 390 pmp in thirteen regions. The overall crude prevalence rate of renal replacement therapy for end-stage renal disease was 929 pmp in thirteen regions, with significant differences in age-adjusted prevalence across regions (732 to 1009 pmh). In the 2002-05 cohort of 11,632 incident patients, the overall one-year survival rate was 82%, 72% at 2 years and 62% at 3 years. Survival decreased with age, but remained above 50% at 2 years in patients older than 75 at RRT initiation. Among the 5,902 new patients starting dialysis in 2005 in the 14 regions, 7% had a BMI lower than 18,5 kg/m2 and 16% a BMI higher than 30. At initiation, 63% had an haemoglobin value lower than 11 g/ l and 9% an albumin value lower than 25 g/l. The first haemodialysis was started in emergency in 30% of the patients and with a catheter in 46%. On December 31, 2005, 8% treated in the dialysis units of the fourteen regions received peritoneal dialysis, of which 35% were treated with automated peritoneal dialysis. 94% of the patients on haemodialysis had 3 sessions per week, with a median duration of 4 hours. In 2005, 1,911 patients received a renal graft. On December 31, 2005, 4,634 patients were on the waiting List for a renal graft in the transplantation centres of the 14 regions.