Finnish Registry for Kidney Diseases Finnish Registry for Finnish Registry for Kidney Diseases Report 2009
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Report 2009 Incidence/million inhabitants 100 GFR (ml/min/1.73 m2) 90 80 >12 70 1011 60 50 89 40 30 67 20 10 <6 0 -97 -98 -99 -00 -01 -02 -03 -04 -05 -06 -07 -08 -09 Year Finnish Registry for Kidney Diseases Finnish Registry for Finnish Registry for Kidney Diseases Report 2009 Contents Finnish Registry for Kidney Diseases 2009.....................................................................................................................3 Board of the Finnish Registry for Kidney Diseases ....................................................................................................4 The Finnish population and its distribution in healthcare districts in 19992009.....................................................5 Healthcare districts and regions in Finland ..................................................................................................................5 The Finnish population according to region, age group, and gender in 19992009.................................................6 Number of new RRT patients and incidence of RRT by healthcare district and region in 19992009 ...................7 Incidence of RRT by age group and gender in 19992009.........................................................................................8 Standardized incidence of RRT in regions in 19992009...........................................................................................9 Standardized incidence of RRT in regions 90 days after the start of RRT in 19992009 ........................................9 Incidence of RRT in regions 90 days after the start of RRT according to age group 19652009..........................10 Incidence of RRT according to diagnosis in 19652009...........................................................................................11 Incidence of RRT according to glomerulus filtration rate (GFR) 19972009.........................................................12 International comparison of incidence of RRT in 2008 ............................................................................................13 Patients in RRT at end of year according to healthcare district and region in 19992009.....................................14 Patients in RRT according to age group and gender in 19992009 .........................................................................15 Standardized prevalence of RRT in regions in 19992009.......................................................................................15 Prevalence of RRT in healthcare districts on 31 December 2009 ............................................................................16 Prevalence of RRT at end of year according to type of treatment in 19652009....................................................17 Prevalence of RRT at end of year according to diagnosis in 19652009.................................................................18 International comparison of prevalence of RRT on 31 December 2008..................................................................19 Number of patient-years of all RRT patients according to diagnosis and type of treatment in 19992009..........20 Net changes in type of treatment in 2009...................................................................................................................21 Mortality of RRT patients by region in 19992009...................................................................................................22 Standardized mortality of RRT patients in regions in 19992009............................................................................22 Standardized mortality of RRT patients in regions (patients who died within 90 days of start of RRT were excluded) in 19992009................................................................................................................22 Prevalence/incidence ratio of RRT according to region in 2009 ..............................................................................23 Prevalence/incidence ratio of RRT according to region (patients who died within 90 days of start of RRT were excluded) in 2009 .......................................................................................................................... 23 Probability of survival of RRT patients according to region in 20002009 ............................................................24 Probability of survival of RRT patients according to region (patients who died within 90 days of start of RRT were excluded) in 20002009................................................................................................................24 Relative risk of death among RRT patients according to region in 20002009 ......................................................25 Adjusted probability of survival among RRT patients 20002009 ..........................................................................25 Relative risk of death among RRT patients according to region (patients who died within 90 days of start of RRT were excluded) in 20002009................................................................................................................26 Adjusted probability of survival among RRT patients (patients who died within 90 days of start of RRT were excluded) in 20002009................................................................................................................26 Prevalence/incidence ratio in 2008. International comparison .................................................................................27 Index of Reports 19982009......................................................................................................................................... 28 Finnish Registry for Kidney Diseases- 2 - Report 2009 Finnish Registry for Kidney Diseases 2009 The Finnish Registry for Kidney Diseases contains highest probability of survival. Regional differences information about dialysis and kidney transplantation decreased when adjusting for age, gender, and patients in Finland since 1964. The coverage of the comorbidities, although these did not explain all the registry is estimated at 9799%. Virtually all patients survival differences between regions. The agree to provide their information, and hospitals effectiveness of RRT may differ slightly between report patient data very thoroughly. High coverage regions, but it is also possible that some regional is vital to obtain an accurate understanding of the differences in patient characteristics could not be situation for dialysis and kidney transplantation adjusted for. patients in Finland. Low coverage can lead to The European ERA-EDTA Registry and the selection bias, which hampers the interpretation of American USRDS Registry annually publish data on the statistics. Consequently, it is important that the incidence and prevalence of RRT in various coverage of the registry remain high. countries. Mortality or survival data, however, have Report 2009 presents up-to-date information on not been published by country. Nevertheless, an the incidence and prevalence of renal replacement estimate of the average survival time of RRT patients therapy (RRT) in Finland. In 2009, incidence was on can be obtained by calculating the prevalence/ average 10% lower than in 20052008. Although incidence ratio for RRT. According to such an analysis, this may be due to normal variation, it is also possible presented on page 27, the survival of Finnish RRT that incidence is actually falling. The figure on the patients is among the best in the world. cover page shows that the estimated glomerular The Finnish Registry for Kidney Diseases is a filtration rate before the start of RRT is lower nowadays national healthcare registry maintained by the Finnish than a few years earlier. This indicates that patients Kidney and Liver Association and financed by enter RRT at a later stage, which may explain the Finlands Slot Machine Association (RAY). Statistics decreased incidence. Improved predialytic treatment in this report were updated using data obtained from may have enabled postponing the start of RRT. On the Registry for the Follow-up of Kidney Trans- the other hand, a recent randomized trial showed plantation Patients, maintained by the Kidney Trans- that late initiation of dialysis does not impair patient plantation Unit of the Helsinki University Central survival (Cooper et al, N Engl J Med 2010;363: Hospital. The Board of the Finnish Registry for Kidney 609619). Diseases thanks all supporters and participating This report contains a special analysis of patient hospitals for their excellent cooperation. survival by region. Our reports annually present patient mortality (number of deaths per 1000 patient- years) by region. Another way to study mortality is Patrik Finne survival analysis, which provides a probability estimate Administrative Director of patient survival as a function of time from the start of RRT. According to an unadjusted analysis, patients Carola Grönhagen-Riska in southern and western regions of Finland had the Chairman of the Board Finnish Registry for Kidney Diseases- 3 - Report 2009 Board of the Finnish Registry for Kidney Diseases Sirpa Aalto, MSc Ilpo Ala-Houhala, Docent Carola Grönhagen-Riska, Professor Eero Honkanen, Docent Risto Ikäheimo, Docent Pauli Karhapää, MD Petri Koskinen, Docent Kaj Metsärinne, Docent Maija Piitulainen Kai Rönnholm, Docent Kaija Salmela, Docent Patrik Finne, Docent Rauni Jukkara, secretary Finnish Registry for Kidney Diseases- 4 - Report 2009 Table 1. The Finnish population and its distribution in healthcare districts.