Dansk Nefrologisk Selskab Årsrapport 2008 James Heaf

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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

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.

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

ESRD Incidence 1990-2007

Timely Referral

Planned Dialysis Start 2008

Dialysis Modality and Start 2008

ESRD Prevalence 2007 & 2008 Per 31.12. 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

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.

Tabel 11: Renal transplantation 1990-2008 1990-94 1995-99 2000-04 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

Initial ESRD Modality

90-day ESRD Modality

Dialysis Prevalence 1990-2007

Oldest Patient

Age at ESRD Initiation

Age at ESRD Initiation

Age and Initial ESRD Modality

Modality Prevalence and Age 1990 vs 2008

Modality Prevalence and Age 1990 vs 2008

Modality Prevalence and Age 1990

Modality Prevalence and Age 2008

Modality Prevalence and Age 1990

Modality Prevalence and Age 2008

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 1990-94, 1995-99, 2000-04, 2005-08 Morbidity factors: age, sex, transplant candidacy, renal diagnosis 1990-2008 8108 patients

Relative Mortality Risk: General Factors First Dialysis Rx only 1990-2008 Prognosis after 3 months

Relative Mortality Risk: Renal Diagnosis

Relative Mortality Risk: Cohort Effect First Dialysis Rx only 1990-2008 Prognosis after 3 months