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Trends in adult renal replacement therapy in the UK: 1982–2002

Trends in adult renal replacement therapy in the UK: 1982–2002
Trends in adult renal replacement therapy in the UK: 1982–2002
BACKGROUND: Following the introduction of dialysis and transplantation for the treatment of established renal failure (ERF) 40 years ago, the UK failed to match the achievements of many other countries. AIM: To review progress with treatment for ERF in the UK in the past 20 years.
DESIGN: Review of four cross-sectional national studies, and 1997-2002 annual UK Renal Registry data.
METHODS: Data on UK patients on renal replacement treatment (RRT) were collated from three sources: European Registry reports for 1982-1990, surveys carried out within the UK in 1993, 1996, 1998 and 2002, and the UK Renal Registry database (1997-2002). Trends in acceptance and prevalence rates, median age, cause of ERF, and treatment modality were analysed and compared with current data from other countries.
RESULTS: The UK annual acceptance rate for RRT increased from 20 per million population (pmp) in 1982 to 101 pmp in 2002. This growth was largely in those aged over 65 years, and in those with co-morbidity. Annual acceptance rates for ERF due to diabetes rose from 1.6 to 18 pmp. The prevalence of RRT increased from 157 pmp in 1982 to 626 pmp in 2002. Hospital haemodialysis has become the main modality, and is increasingly being provided in satellite units. Although rising, UK acceptance and prevalence rates are still lower than in many developed countries.
DISCUSSION: Despite significant expansion in RRT services for adults in the UK over the last 20 years, there is evidence of unmet need, and need is expected to rise, due to demographic changes and trends in type 2 diabetes. Continuing growth in the already substantial investment in RRT will be needed, unless efforts to prevent the occurrence of ERF are successful.
patients, Great Britain, chronic, treatment, registries, renal replacement therapy, infant, child, report, sex distribution, prevalence, etiology, diabetes, age distribution, health services needs and demand, supply & distribution, newborn, developed countries, comorbidity, epidemiology, population, adolescent, trends, growth, therapy, humans, hospital units, kidney failure, needs assessment, preschool, aged, methods, non-U.S.gov't, middle aged, diabetic nephropathies, transplantation, utilization, cross-sectional studies, design, adult, research support, review
1460-2725
21-28
Feest, T.G.
5c5d15d9-ff28-4130-93e7-796d088fef6f
Rajamahesh, J.
f672a162-e9d0-4a71-a008-0e267acc4347
Byrne, C.
1370b997-cead-4229-83a7-53301ed2a43c
Ahmad, A.
2c47be8e-9351-4335-a3e8-148aba31d1a8
Ansell, D.
4849c1d3-9ff9-46ac-91e5-b4c6d7a6b52f
Burden, R.
a0fd4c5a-9df3-4658-8bf8-072e9e0af44b
Roderick, P.J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Feest, T.G.
5c5d15d9-ff28-4130-93e7-796d088fef6f
Rajamahesh, J.
f672a162-e9d0-4a71-a008-0e267acc4347
Byrne, C.
1370b997-cead-4229-83a7-53301ed2a43c
Ahmad, A.
2c47be8e-9351-4335-a3e8-148aba31d1a8
Ansell, D.
4849c1d3-9ff9-46ac-91e5-b4c6d7a6b52f
Burden, R.
a0fd4c5a-9df3-4658-8bf8-072e9e0af44b
Roderick, P.J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a

Feest, T.G., Rajamahesh, J., Byrne, C., Ahmad, A., Ansell, D., Burden, R. and Roderick, P.J. (2005) Trends in adult renal replacement therapy in the UK: 1982–2002. QJM: An International Journal of Medicine, 98 (1), 21-28. (doi:10.1093/qjmed/hci007).

Record type: Article

Abstract

BACKGROUND: Following the introduction of dialysis and transplantation for the treatment of established renal failure (ERF) 40 years ago, the UK failed to match the achievements of many other countries. AIM: To review progress with treatment for ERF in the UK in the past 20 years.
DESIGN: Review of four cross-sectional national studies, and 1997-2002 annual UK Renal Registry data.
METHODS: Data on UK patients on renal replacement treatment (RRT) were collated from three sources: European Registry reports for 1982-1990, surveys carried out within the UK in 1993, 1996, 1998 and 2002, and the UK Renal Registry database (1997-2002). Trends in acceptance and prevalence rates, median age, cause of ERF, and treatment modality were analysed and compared with current data from other countries.
RESULTS: The UK annual acceptance rate for RRT increased from 20 per million population (pmp) in 1982 to 101 pmp in 2002. This growth was largely in those aged over 65 years, and in those with co-morbidity. Annual acceptance rates for ERF due to diabetes rose from 1.6 to 18 pmp. The prevalence of RRT increased from 157 pmp in 1982 to 626 pmp in 2002. Hospital haemodialysis has become the main modality, and is increasingly being provided in satellite units. Although rising, UK acceptance and prevalence rates are still lower than in many developed countries.
DISCUSSION: Despite significant expansion in RRT services for adults in the UK over the last 20 years, there is evidence of unmet need, and need is expected to rise, due to demographic changes and trends in type 2 diabetes. Continuing growth in the already substantial investment in RRT will be needed, unless efforts to prevent the occurrence of ERF are successful.

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Published date: 2005
Related URLs:
Keywords: patients, Great Britain, chronic, treatment, registries, renal replacement therapy, infant, child, report, sex distribution, prevalence, etiology, diabetes, age distribution, health services needs and demand, supply & distribution, newborn, developed countries, comorbidity, epidemiology, population, adolescent, trends, growth, therapy, humans, hospital units, kidney failure, needs assessment, preschool, aged, methods, non-U.S.gov't, middle aged, diabetic nephropathies, transplantation, utilization, cross-sectional studies, design, adult, research support, review
Organisations: Community Clinical Sciences

Identifiers

Local EPrints ID: 24332
URI: http://eprints.soton.ac.uk/id/eprint/24332
DOI: doi:10.1093/qjmed/hci007
ISSN: 1460-2725
PURE UUID: 6aea3241-d120-4e9f-a8a9-4b7bab7c5cbb
ORCID for C. Byrne: ORCID iD orcid.org/0000-0001-6322-7753
ORCID for P.J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 30 Mar 2006
Last modified: 16 Mar 2024 03:07

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Contributors

Author: T.G. Feest
Author: J. Rajamahesh
Author: C. Byrne ORCID iD
Author: A. Ahmad
Author: D. Ansell
Author: R. Burden
Author: P.J. Roderick ORCID iD

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