Dansk Nefrologisk Selskab Årsrapport 2008

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1 Dansk Nefrologisk Selskab Årsrapport 2008
James Heaf

2 This Power Point presentation belongs to the Danish Renal Registry, which owns the copyright. It can be freely used for non-commercial study and educational purposes. Any commercial use or publication requires the prior permission of the Danish Renal Registry.

3 DNSL & ESRD Alle transplanterede patienter har ESRD
Alle patienter hvor lægen tror at patienten har ESRD ved første dialyse har ESRD Alle patienter som dialyseres i mindst 90 dage har ESRD Patienter, hvor man er i tvivl (ATIN, halvmånenefritis), har ESRD så snart tvivlen er fjernet, eller patienten har fået dialyse i 3 måneder

4 Akut vs. Rutine Dialyseopstart
HD AV Fistel Permakteter som permanent adgangsvej Midlertidig dialysekateter Permkateter hvor der senere planlægges AV fistel PD Ambulant opstart Opstart under indlæggelse* *: Hvis patienten er indlagt som ren socialforanstaltning, f. eks patienthotel, tæller det med som rutineopstart.

5 Akut vs. Rutine Opstart af PD: Ny Definition
Gammel Definition Ny Definition Akut Opstart Opstart under Indlæggelse Opstart <7 dage efter anlæggelse af peritoneal dialysekateter Rutine Opstart Ambulant Opstart Opstart >6 dage efter anlæggelse af peritoneal dialysekateter

6 ESRD Incidence

7 Timely Referral

8 Planned Dialysis Start 2008

9 Dialysis Modality and Start 2008

10 ESRD Prevalence 2007 & 2008 Per 2007 2008 Total in treatment: 4395 4448 Transplantation 1735 1831 In dialysis 2660 2617 ↓ Types of dialysis: HD 1989 2001 PD 648 591 HD+PD 23 25 Specific types of dialysis: HD-Centre 1774 1780 HD-Centre: Lim. care 105 102 HD-Home 110 119 PD-Centre: IPD 6 7 PD-Home: CAPD 199 185 PD-Home: APD 443 399 PD+HD

11 Tabel 12 : Centreopgørelse / Transplantation by transplant center 2008
Rigshospit alet Herlev Odense Skejby Overall 52 25 45 67 189 Source of donor Transplant number Dead donor 1 30 15 10 38 93 2 5 3 8 18 4 Living donor 13 27 17 61 A further 3 patients without Danish CPR-numbers were transplanted at Rigshospitalet.

12 Tabel 11: Renal transplantation 1990-2008
2005 2006 2007 2008 N % Overall 843 100 747 808 162 164 189 Source of donor TX number Dead donor 1 500 59.3 449 60.1 490 60.6 92 56.8 88 53.7 89 54.9 93 49.2 2 114 13.5 79 10.6 102 12.6 17 10.5 15 9.1 9.3 18 9,5 3 21 2.5 22 2.9 16 2.0 4 1.2 1.6 0.2 0.3 0.4 0.6 0.0 1.1 5 0.1 Living donor 19.5 179 24.0 175 21.7 41 25.3 49 29.9 44 27.2 61 32,3 31 3.7 2.2 7 4.3 9 5.5 11 6.8 4,8 0.8 0.5

13 Initial ESRD Modality

14 90-day ESRD Modality

15

16 Dialysis Prevalence

17 Oldest Patient

18

19 Age at ESRD Initiation

20 Age at ESRD Initiation

21 Age and Initial ESRD Modality

22 Modality Prevalence and Age 1990 vs 2008

23 Modality Prevalence and Age 1990 vs 2008

24 Modality Prevalence and Age 1990

25 Modality Prevalence and Age 2008

26 Modality Prevalence and Age 1990

27 Modality Prevalence and Age 2008

28

29 Risk Factors for Dialysis Death
Cox proportional hazards regression analysis First dialysis RX only Survival after 3 months Dialysis modality at 3 months (HD vs. PD) Censored for modality change, transplantation Cohorts , , , Morbidity factors: age, sex, transplant candidacy, renal diagnosis 8108 patients

30 Relative Mortality Risk: General Factors
First Dialysis Rx only Prognosis after 3 months

31 Relative Mortality Risk: Renal Diagnosis

32 Relative Mortality Risk: Cohort Effect
First Dialysis Rx only Prognosis after 3 months