Survival on renal replacement therapy: data from the EDTA Registry

Area of Science:

• Nephrology
• Public Health
• Transplantation Medicine

Background:

• Extensive survival data from the EDTA Registry for patients initiating renal replacement therapy (RRT) between 1970-1974 and 1980-1984 were analyzed.
• The study examines survival trends across different treatment modalities and geographical regions.
• Comparison of RRT outcomes between two distinct eras provides insights into evolving patient care.

Purpose of the Study:

• To compare patient survival rates for renal replacement therapy (RRT) between the periods 1970-1974 and 1980-1984.
• To assess the impact of age, treatment modality, and primary renal disease on RRT survival.
• To evaluate the outcomes of first, second, and third kidney transplantations.

Main Methods:

• Analysis of extensive survival data from the EDTA Registry.
• Comparison of patient survival based on age, treatment modality (haemodialysis, peritoneal dialysis, transplantation), and primary renal disease.
• Evaluation of patient and graft survival rates for first, second, and third kidney transplants.

Main Results:

• Overall patient and graft survival rates significantly improved from the early 1970s to the early 1980s, particularly for cadaveric transplantation.
• Younger patients (10-14 years) exhibited the best survival rates on RRT, while survival decreased with increasing age.
• Diabetic nephropathy patients had 2-3 times higher mortality rates compared to those with 'standard' renal diseases. Second and third graft survival showed mixed results depending on previous graft function and rejection.

Conclusions:

• Renal replacement therapy outcomes have markedly improved over a decade, with significant gains in transplantation.
• Age remains a critical determinant of survival on RRT, with pediatric patients faring better.
• While overall transplant survival is improving, outcomes for subsequent grafts in specific patient groups require further investigation.