|
8 Appendices
Appendix II
Source: Locatelli F, Valderrabano F, Heonich N, Bommer
J, Leunissen K, Cambi V.
Progress in dialysis technology: membrane selection and patient outcome.
Nephrol Dial Transplant (2000)
15: 1133-1139.
Note: these data were taken from the following sources for the year 1998:
European dialysis and Transplant Association (EDTA) returns, Perilon database,
The Registratie Nierfuncievervanging Nederland (RENINE), Membrana GmbH
market research report. In 1998 only the Netherlands had a comprehensive
national renal registry covering the whole country. The UK Renal Registry
now covers over 50% of the country and will shortly be able to provide
accurate prevalence data. Meanwhile the figures quoted here should be
taken as an approximate guide. The comments are from the above authors.
| |
Germany
pop 81.7 million |
No.
of Patients
(% total) |
Prevalence
pmp |
Acceptance
pmp.pa |
|
|
| |
| Transplant |
15,441 (24%) |
189 |
30 |
|
Dialysis (All)
|
49,239 (76%) |
602 |
162 |
| HD |
45,766 (71%) |
560 |
145 |
| PD |
3,473 (5%) |
40 |
17 |
| All ESRF |
64,640 (100%) |
791 |
162*
|
|
|
|
Germany has the highest number of patients under treatment
for ESRF in Europe. This is mainly due to the very large population of
HD patients, supported with a strong transplantation sector, although
the proportion of PD patients remains low at 5%. The number of new patients
remains high for both HD and transplantation.
| |
Netherlands
pop 15.5 million |
No.
of Patients
(% total) |
Prevalence
pmp |
Acceptance
pmp.pa |
|
|
| |
| Transplant |
4,290 (50%) |
277 |
29 |
|
Dialysis (All)
|
4299 (50%) |
273 |
81 |
| HD |
3,053 (36%) |
197 |
57 |
| PD |
1,246 (14%) |
80 |
24 |
| All ESRF |
8,589 (100%) |
554 |
81*
|
|
|
|
Statistics for ESRF treatment are carefully documented
in the Netherlands. The overall treatment rate is relatively low. Transplantation
plays the largest part, although the new patient rate is only average.
The PD sector is proportionately larger. HD has not developed as far as
might be anticipated. Regulations do not allow private sector dialysis
facilities.
| |
UK
pop 58.6 million |
No.
of Patients
(% total) |
Prevalence
pmp |
Acceptance
pmp.pa |
|
|
| |
| Transplant |
15,689 (24%) |
268 |
25 |
|
Dialysis (All)
|
13,484 (46%) |
230 |
87 |
| HD |
8,162 (28%) |
139 |
55 |
| PD |
5,322 (18%) |
91 |
32 |
| All ESRF |
29,173 (100%) |
498 |
87*
|
|
|
|
The UK was one of the forerunners in Europe of ESRD treatment.
However, in recent years there has been a lack of resources devoted to the
therapy and thus, inadequate treatment rates have been noted.
The previous high transplantation rate has decreased to below average. The
HD sector has been neglected in favour of PD which until recently accounted
for half of the patients on chronic dialysis. However, lack of long-term
adequacy of PD has prompted an increase in HD facilities, although the number
of new patients is still relatively low.
| |
Spain
pop 39.1 million |
No.
of Patients
(% total) |
Prevalence
pmp |
Acceptance
pmp.pa |
|
|
| |
| Transplant |
11,142 (39%) |
285 |
45 |
|
Dialysis (All)
|
17,804 (61%) |
456 |
120 |
| HD |
16,327 (56%) |
418 |
104 |
| PD |
1,477 (5%) |
38 |
16 |
| All ESRF |
28,946 (100%) |
741 |
120*
|
|
|
|
Spain has increased the treatment of ESRF in recent years
and overall treatment and new patient rates are relatively high. Most notable
is the large number of transplant patients and the continuing high number
of new patients of 45 pmp, a result of the conscious decision some years
ago to concentrate on organ replacement. HD therapy has been developed and
the new patient rate is now similar to that in Italy.
| |
Italy
pop 57.7 million |
No.
of Patients
(% total) |
Prevalence
pmp |
Acceptance
pmp.pa |
|
|
| |
| Transplant |
9,856 (20%) |
171 |
24 |
|
Dialysis (All)
|
39,417 (80%) |
683 |
130 |
| HD |
34,214 (69%) |
593 |
104 |
| PD |
5,203 (11%) |
90 |
26 |
| All ESRF |
49,273 (100%) |
854 |
130*
|
|
|
|
The overall treatment rate (prevalence) in Italy for
ESRD is the highest in Europe, mainly due to a high concentration on HD
(at 593 pmp, this is even higher than that of Germany). This is augmented
by a PD penetration rate of 11%. Whilst the transplantation rate is lower
than average, the PD sector is more developed.
| |
France
pop 81.7 million |
No.
of Patients
(% total) |
Prevalence
pmp |
Acceptance
pmp.pa |
|
|
| |
| Transplant |
12,255 (33%) |
211 |
28 |
|
Dialysis (All)
|
24,553 (67%) |
423 |
111 |
| HD |
21,950 (60%) |
378 |
89 |
| PD |
2,603 (7%) |
45 |
22 |
| All ESRF |
36,808 (100%) |
634 |
111*
|
|
|
|
France has a fairly high overall treatment rate of 634
pmp, predominantly from the HD sector. The overall new patient rate is
not particularly high at 111 pmp For HD, the new patient rate is 89 pmp,
significantly lower than in both Spain and Italy. The transplantation
rate is now only 28 pmp.
| |
| |
Germany,
Netherlands, Spain,
Italy, France Pop 252.1 million
|
UK
Pop
58.6 million
|
|
|
| |
| |
Patient No.
(% total) |
Prevalence
PMP
|
Patient No.
(% total) |
Prevalence
PMP |
| Transplant |
52,984 (28%) |
210 |
15,689 (54%) |
268 |
| Dialysis (All) |
135,312 (72%)
|
537 |
13,484 (46%) |
230 |
| HD |
121,310 (64%) |
481 |
8,162 (28%) |
139 |
| PD |
14,002 (8%) |
56 |
5,322 (18%) |
91 |
| All ESRF |
188,296 (100%) |
747 |
29,173 (100%) |
498
|
|
|
|
* To avoid double counting, acceptance for all
ESRF includes only those taken onto dialysis since the majority of new
transplants are accepted onto dialysis first
|
