O R I G I N A L A R T I C L E

The European Renal Association ndash European Dialysis

and Transplant Association Registry Annual Report

2014 a summaryMaria Pippias1 Anneke Kramer1 Marlies Noordzij1 Nikolaos Afentakis2Ramon Alonso de la Torre3 Patrice M Ambuhl4 Manuel I Aparicio Madre5Felipe Arribas Monzon6 Anders Asberg7 Marjolein Bonthuis8Encarnacion Bouzas Caama~no9 Ivan Bubic10 Fergus J Caskey11Pablo Castro de la Nuez12 Harijs Cernevskis13Maria de los Angeles Garcia Bazaga14 Jean-Marin des Grottes15Raquel Fernandez Gonzalez16 Manuel Ferrer-Alamar17 Patrik Finne1819Liliana Garneata20 Eliezer Golan21 James G Heaf22 Marc H Hemmelder23Alma Idrizi24 Kyriakos Ioannou25 Faical Jarraya26 Nino Kantaria27Mykola Kolesnyk28 Reinhard Kramar29 Mathilde Lassalle30Visnja V Lezaic31 Frantisek Lopot32 Fernando Macario33 Angela Magaz34Angel L Martın de Francisco35 Eduardo Martın Escobar36Alberto Martınez Castelao37 Wendy Metcalfe38 Inmaculada Moreno Alia39Maurizio Nordio40 Mai Ots-Rosenberg41 Runolfur Palsson4243Marina Ratkovic44 Halima Resic45 Boleslaw Rutkowski46Carmen Santiuste de Pablos47 Nurhan Seyahi48Marıa Fernanda Slon Roblero49 Viera Spustova50 Koenraad JF Stas51Marıa E Stendahl52 Olivera Stojceva-Taneva53 Evgueniy Vazelov54Edita Ziginskiene555657 Ziad Massy5859 Kitty J Jager1 and Vianda S Stel1

1ERA-EDTA Registry Department of Medical Informatics Academic Medical Center University of AmsterdamAmsterdam The Netherlands 2Hellenic Renal Registry Board of Registry Coordination and Control of RRTGeneral Hospital of Athens lsquoG Gennimatasrsquo Athens Greece 3Public Health Directorate Asturias Spain4Swiss Dialysis Registry Renal Division Stadtspital Waid Zurich Switzerland 5Registro Madrile~no de

Received September 20 2016 Accepted November 7 2016

VC The Author 2017 Published by Oxford University Press on behalf of ERA-EDTAThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (httpcreativecommonsorglicensesby-nc40) which permits non-commercial re-use distribution and reproduction in any medium provided the original work is properly citedFor commercial re-use please contact journalspermissionsoupcom

154

Clinical Kidney Journal 2017 vol 10 no 2 154ndash169

doi 101093ckjsfw135Advance Access Publication Date 16 January 2017Original Article

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Enfermos Renales (REMER) Oficina Regional de Coordinacion de Trasplantes Madrid Spain 6Aragon RenalRegistry Coordinacion de Trasplantes de Aragon Zaragoza Spain 7Norwegian Renal Registry Department ofTransplant Medicine Oslo University Hospital ndash Rikshospitalet Oslo Norway 8ESPNERA-EDTA RegistryDepartment of Medical Informatics Academic Medical Center University of Amsterdam Amsterdam TheNetherlands 9Regional Transplant Coordination Office Galicia Spain 10Department of Internal MedicineClinical Hospital Centre Rijeka School of Medicine University of Rijeka Rijeka Croatia 11UK Renal RegistryLearning and Research Southmead Hospital Bristol UK 12Information System of Regional TransplantCoordination in Andalucia (SICATA) Andalucia Spain 13Department of Internal Medicine Riga StradinsUniversity Riga Latvia 14Direccion General de Salud Publica Servicio Extreme~no de Salud Consejerıa deSanidad y Polıticas Sociales Junta de Extremadura Caceres Spain 15CHU Tivoli La Louviere Belgium16Registro de Enfermos Renales de Castilla y Leon Coordinacion de Trasplantes Castilla y Leon Spain17Tecnico Registro de Enfermos Renales Comunitat Valenciana Servicio de Estudios Epidemiologicos yRegistros Sanitarios Subdireccion General Epidemiologıa Direccion General Salut Publica Consellerıa SanitatValencian Region Spain 18Department of Nephrology Helsinki University Central Hospital Helsinki Finland19Finnish Registry for Kidney Diseases Helsinki Finland 20Department of Internal Medicine and NephrologylsquoDr Carol Davilarsquo Teaching Hospital of Nephrology lsquoCarol Davilarsquo University of Medicine and PharmacyBucharest Romania 21Department of Nephrology and Hypertension Meir Medical Center Kfar-Saba andSackler Faculty of Medicine Tel Aviv Israel 22Department of Medicine Zealand University Hospital RoskildeDenmark 23Dutch Renal Registry (Renine) Nefrovisie Utrecht The Netherlands 24Service of NephrologyUHC lsquoMother Teresarsquo Tirana Albania 25Nephrology Department Nicosia General Hospital Nicosia Cyprus26Research Unit 12ES14 Faculty of Medicine Sfax University and Hedi Chaker University Hospital SfaxTunisia 27Department of Internal Medicine Tbilisi State Medical University Tbilisi Georgia 28MainCoordinator of National Register of CKD and AKI Patients State Institute of Nephrology National Academy ofMedical Sciences of Ukraine Kiev Ukraine 29Austrian Dialysis and Transplant Registry Rohr Austria 30REINRegistry Agence de la Biomedecine Paris France 31Department of Nephrology Clinical Centre of SerbiaBelgrade Serbia 32Department of Medicine General University Hospital and 1st Charles University MedicalSchool Strahov Czech Republic 33Nephrology Department Portuguese Society of Nephrology UniversityHospital of Coimbra Coimbra Portugal 34Unidad de Informacion sobre Pacientes Renales de la ComunidadAutonoma del Paıs Vasco (UNIPAR) Basque Country Spain 35Servicio de Nefrologıa Hospital UniversitarioValdecilla Santander Cantabria Spain 36Registro Espa~nol de Enfermos Renales (REER) OrganizacionNacional de Trasplantes Madrid Spain 37Member of the Catalan Renal Registry Committee HospitalUniversitari de Bellvitge LrsquoHospitalet de Llobregat Barcelona Spain 38Scottish Renal Registry MeridianCourt ISD Scotland Glasgow UK 39Registro de Enfermos Renales en Tratamiento Sustitutivo de Castilla-LaMancha Servicio de Epidemiologıa Direccion General de Salud Publica y Consumo Castilla-La ManchaToledo Spain 40Nephrology and Dialysis Unit AULSS 15 Veneto Italy 41Department of Internal MedicineFaculty of Medicine Institute of Clinical Medicine Tartu University Tartu Estonia 42Division of NephrologyLandspitali ndash The National University Hospital of Iceland Reykjavık Iceland 43Faculty of Medicine School ofHealth Sciences University of Iceland Reykjavik Iceland 44Nephrology and Hemodialysis DepartmentClinical Center of Montenegro Ljubljanska Montenegro 45Head of Clinic for Hemodialysis Clinical CenterUniversity of Sarajevo Sarajevo Bosnia and Herzegovina 46Polish Renal Registry Department of NephrologyTransplantology and Internal Medicine Medical University Gdansk Poland 47Registro de Enfermos Renalesde la Region de Murcia Servicio de Epidemiologıa Consejerıa de Sanidad IMIB-Arrixaca Murcia Spain48Department of Internal Medicine Cerrahpasa Medical Faculty Division of Nephrology Istanbul UniversityIstanbul Turkey 49Consultant Nephrologist at Complejo Hospitalario de Navarra Complejo Hospitalario deNavarra Pamplona Navarra Spain 50Slovak Medical University Bratislava Slovakia 51Dienst NefrologieJessa Ziekenhuis Campus Virga Jesse Hasselt Belgium 52Swedish Renal Registry Department of MedicineRyhov County Hospital Jonkoping Sweden 53University Clinic of Nephrology Medical Faculty of SkopjeSkopje Macedonia 54Dialysis Clinic lsquoAlexandrovskarsquo University Hospital Sofia Medical University SofiaBulgaria 55Lithuanian Nephrology Dialysis and Transplantation Association Kaunas Lithuania56Department of Nephrology Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania

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57Nephrological Clinic Hospital of Lithuanian University of Health Sciences Kaunas Clinics KaunasLithuania 58Division of Nephrology Ambroise Pare University Hospital APHP Boulogne-Billancourt Franceand 59Institut National de la Sante et de la Recherche Medicale (INSERM) U1018 Team 5 CESP UVSQ andUniversity Paris Saclay Villejuif France

Correspondence and offprint requests to Maria Pippias E-mail mpippiasamcuvanl

Abstract

Background This article summarizes the European Renal Association ndash European Dialysis and Transplant AssociationRegistryrsquos 2014 annual report It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease(ESRD) in 2014 within 35 countries

Methods In 2016 the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD from 51national or regional renal registries Thirty-two registries provided individual patient level data and 19 provided aggregatedpatient level data The incidence prevalence and survival probabilities of these patients were determined

Results In 2014 70 953 individuals commenced RRT for ESRD equating to an overall unadjusted incidence rate of 133 permillion population (pmp) The incidence ranged by 10-fold from 23 pmp in the Ukraine to 237 pmp in Portugal Of the pa-tients commencing RRT almost two-thirds were men over half were aged65 years and a quarter had diabetes mellitus astheir primary renal diagnosis By day 91 of commencing RRT 81 of patients were receiving haemodialysis On 31December 2014 490 743 individuals were receiving RRT for ESRD equating to an unadjusted prevalence of 924 pmpThis ranged throughout Europe by more than 10-fold from 157 pmp in the Ukraine to 1794 pmp in Portugal In 2014 19 406kidney transplantations were performed equating to an overall unadjusted transplant rate of 36 pmp Again this variedconsiderably throughout Europe For patients commencing RRT during 2005ndash09 the 5-year-adjusted patient survival proba-bilities on all RRT modalities was 633 (95 confidence interval 630ndash636) The expected remaining lifetime of a 20- to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 219 and 440 years respectively Thiswas substantially lower than the 618 years of expected remaining lifetime of a 20-year-old patient without ESRD

Key words dialysis epidemiology ESRD kidney transplantation survival analysis

Introduction

The European Renal Association ndash European Dialysis and TransplantAssociation (ERA-EDTA) Registryrsquos annual report describes the epi-demiology of renal replacement therapy (RRT) for end-stage renaldisease (ESRD) within Europe and adjacent countries based on datacollected via the national and regional renal registries [1] On an an-nual basis we publish a summary of the ERA-EDTA Registryrsquos an-nual report that is intended to provide the reader with an overviewof the current status of RRT for ESRD in Europe [2ndash4] In 2016 wereceived the 2014 data from 51 national or regional renal registries in35 countries covering a general population of 5317 million peopleThis represented 654 of the 2014 European general populationThirty-two national or regional renal registries from 17 countries pro-vided individual patient data whereas 19 countries or regions pro-vided aggregated data (see Appendix 1) The proportion of theEuropean population covered by the ERA-EDTA Registry in 2014 waslower than that of 2013 (736) due to the absence of Russia andSlovenia from this yearrsquos annual report

This summary presents the 2014 incidence and prevalenceof patients receiving RRT kidney transplantation activity andthe patient and graft survival in these 35 countries The meth-ods used to derive the results presented in this overview alongwith the full results can be found in the ERA-EDTA Registry2014 Annual Report [1]

Incidence of RRT

In 2014 70 953 individuals commenced RRT for ESRD whichequated to an overall unadjusted incidence rate of 133 per

million population (pmp Table 1) The unadjusted incidencerate was highest in Portugal (237 pmp) Greece (218 pmp) andCyprus (204 pmp) whereas it was lowest in the Ukraine (23pmp) and Iceland (58 pmp Table 1 and Figures 1 and 2) Of thepatients commencing RRT the majority were men (63) overhalf were aged65 years (55) and a quarter had diabetes melli-tus (26) as their primary renal diagnosis (Figure 3) The meanage of the patients commencing RRT in all countries and re-gions combined was 646 years (Table 1) However this rangedfrom a mean age of 551 years in Albania to 701 years in Dutch-speaking Belgium Of the incident patients alive and receivingRRT at day 91 after the start of treatment the majority werereceiving haemodialysis (81) 13 were receiving peritonealdialysis and 6 were living with a kidney transplant (Figure 4)However the modality of RRT at day 91 after the start of treat-ment varied considerably between age groups as the age of thepatient increased the proportion of patients receiving eitherperitoneal dialysis or living with a kidney transplant decreasedFurthermore patients with a primary renal diagnosis of dia-betes mellitus were half as likely to have a kidney transplant byday 91 compared with the non-diabetic group (3 versus 7)

Prevalence of RRT

On 31 December 2014 490 743 individuals were receiving RRTfor ESRD (Table 2) This equated to an unadjusted prevalence of924 pmp Again there was considerable variation between coun-tries with the highest unadjusted prevalence rates seen inPortugal (1794 pmp) the Spanish regions of Catalonia (1312pmp) Valencia (1298 pmp) Galicia (1265 pmp) and Murcia (1258

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57Nephrological Clinic Hospital of Lithuanian University of Health Sciences Kaunas Clinics KaunasLithuania 58Division of Nephrology Ambroise Pare University Hospital APHP Boulogne-Billancourt Franceand 59Institut National de la Sante et de la Recherche Medicale (INSERM) U1018 Team 5 CESP UVSQ andUniversity Paris Saclay Villejuif France

Correspondence and offprint requests to Maria Pippias E-mail mpippiasamcuvanl

Abstract

Background This article summarizes the European Renal Association ndash European Dialysis and Transplant AssociationRegistryrsquos 2014 annual report It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease(ESRD) in 2014 within 35 countries

Methods In 2016 the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD from 51national or regional renal registries Thirty-two registries provided individual patient level data and 19 provided aggregatedpatient level data The incidence prevalence and survival probabilities of these patients were determined

Results In 2014 70 953 individuals commenced RRT for ESRD equating to an overall unadjusted incidence rate of 133 permillion population (pmp) The incidence ranged by 10-fold from 23 pmp in the Ukraine to 237 pmp in Portugal Of the pa-tients commencing RRT almost two-thirds were men over half were aged65 years and a quarter had diabetes mellitus astheir primary renal diagnosis By day 91 of commencing RRT 81 of patients were receiving haemodialysis On 31December 2014 490 743 individuals were receiving RRT for ESRD equating to an unadjusted prevalence of 924 pmpThis ranged throughout Europe by more than 10-fold from 157 pmp in the Ukraine to 1794 pmp in Portugal In 2014 19 406kidney transplantations were performed equating to an overall unadjusted transplant rate of 36 pmp Again this variedconsiderably throughout Europe For patients commencing RRT during 2005ndash09 the 5-year-adjusted patient survival proba-bilities on all RRT modalities was 633 (95 confidence interval 630ndash636) The expected remaining lifetime of a 20- to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 219 and 440 years respectively Thiswas substantially lower than the 618 years of expected remaining lifetime of a 20-year-old patient without ESRD

Key words dialysis epidemiology ESRD kidney transplantation survival analysis

Introduction

The European Renal Association ndash European Dialysis and TransplantAssociation (ERA-EDTA) Registryrsquos annual report describes the epi-demiology of renal replacement therapy (RRT) for end-stage renaldisease (ESRD) within Europe and adjacent countries based on datacollected via the national and regional renal registries [1] On an an-nual basis we publish a summary of the ERA-EDTA Registryrsquos an-nual report that is intended to provide the reader with an overviewof the current status of RRT for ESRD in Europe [2ndash4] In 2016 wereceived the 2014 data from 51 national or regional renal registries in35 countries covering a general population of 5317 million peopleThis represented 654 of the 2014 European general populationThirty-two national or regional renal registries from 17 countries pro-vided individual patient data whereas 19 countries or regions pro-vided aggregated data (see Appendix 1) The proportion of theEuropean population covered by the ERA-EDTA Registry in 2014 waslower than that of 2013 (736) due to the absence of Russia andSlovenia from this yearrsquos annual report

This summary presents the 2014 incidence and prevalenceof patients receiving RRT kidney transplantation activity andthe patient and graft survival in these 35 countries The meth-ods used to derive the results presented in this overview alongwith the full results can be found in the ERA-EDTA Registry2014 Annual Report [1]

Incidence of RRT

In 2014 70 953 individuals commenced RRT for ESRD whichequated to an overall unadjusted incidence rate of 133 per

million population (pmp Table 1) The unadjusted incidencerate was highest in Portugal (237 pmp) Greece (218 pmp) andCyprus (204 pmp) whereas it was lowest in the Ukraine (23pmp) and Iceland (58 pmp Table 1 and Figures 1 and 2) Of thepatients commencing RRT the majority were men (63) overhalf were aged65 years (55) and a quarter had diabetes melli-tus (26) as their primary renal diagnosis (Figure 3) The meanage of the patients commencing RRT in all countries and re-gions combined was 646 years (Table 1) However this rangedfrom a mean age of 551 years in Albania to 701 years in Dutch-speaking Belgium Of the incident patients alive and receivingRRT at day 91 after the start of treatment the majority werereceiving haemodialysis (81) 13 were receiving peritonealdialysis and 6 were living with a kidney transplant (Figure 4)However the modality of RRT at day 91 after the start of treat-ment varied considerably between age groups as the age of thepatient increased the proportion of patients receiving eitherperitoneal dialysis or living with a kidney transplant decreasedFurthermore patients with a primary renal diagnosis of dia-betes mellitus were half as likely to have a kidney transplant byday 91 compared with the non-diabetic group (3 versus 7)

Prevalence of RRT

On 31 December 2014 490 743 individuals were receiving RRTfor ESRD (Table 2) This equated to an unadjusted prevalence of924 pmp Again there was considerable variation between coun-tries with the highest unadjusted prevalence rates seen inPortugal (1794 pmp) the Spanish regions of Catalonia (1312pmp) Valencia (1298 pmp) Galicia (1265 pmp) and Murcia (1258

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Table 1 Incidence of RRT in 2014 at day 1 for all primary renal diseases combined and diabetes mellitus types 1 and 2 by count (N) and un-adjusted rate per million population and for all primary renal diseases combined the mean age at the start of RRT presented by countryregion

General population coveredby the registry in thousands

Incidence in 2014 at day 1

Total N Total pmp Mean age DM N DM pmp

Albania 2863 252 88 551 30 11Austria 8508 1036 122 642 259 30Belgium Dutch-speakinga 6444 1145 178 701 207 32Belgium French-speakinga 4788 828 173 675 188 39Bosnia and Herzegovina 3508 421 120 607 125 36Bulgariab 7217 1197 166 281 39Croatia 4070 640 157 637 186 46Cyprus 847 173 204 646 58 69Czech Republicb 10 222 2017 197Denmark 5700 748 131 642 184 32Estonia 1315 115 88 611 20 15Finland 5462 461 84 593 165 30France 66 262 10 791 163 676 2379 36Georgia 4491 743 166 584 159 35Greece 10 892 2372 218 697 575 53Iceland 327 19 58 620 1 3Israel 8216 1668 203 646 807 98Italy (6 of 20 regions) 21 274 3243 152 686 558 26Latvia 1590 152 96 633 23 15Lithuania 2943 306 104 578 48 16Macedonia 2022 268 133 632 62 31Montenegroa 622 58 93 562 20 32Norway 5137 523 102 624 90 18Poland 36 338 4341 120Portugal 10 427 2473 237 790 76Romania 19 710 2997 152 611 442 22Serbia 7131 985 138 612 250 35Slovakia 5421 831 153 638 316 58Spain 46 771 6229 133 630 1520 33Spain Andalusia 8394 1046 125 626 270 32Spain Aragon 1329 163 123 641 40 30Spain Asturias 1059 147 139 645 33 31Spain Basque country 2166 241 111 655 39 18Spain Cantabriaa 587 61 104 614 12 21Spain Castile and Leona 2487 299 120 676 79 32Spain Castile-La Manchaa 2069 252 122 637 62 30Spain Catalonia 7519 1178 157 660 259 34Spain Extremadura 1100 124 113 660 28 26Spain Galicia 2741 398 145 650 114 42Spain Community of Madrid 6454 828 128 643 201 31Spain Region of Murcia 1467 194 132 629 46 31Spain Navarrea 636 83 130 650 14 22Spain Valencian region 5005 704 141 659 156 31Sweden 9696 1168 121 625 273 28Switzerlandc 8230 800 97 645 157 19The Netherlands 16 865 1941 115 636 358 21Tunisia Sfax region 1186 165 139 601 59 50Turkeyd 77 696 11 447 147 1042 13Ukraine 42 903 998 23 196 5UK Englanda 54 317 6311 116 623 1441 27UK Northern Irelanda 1840 170 92 646 39 21UK Scotland 5348 557 104 588 164 31UK Walesa 3092 364 118 655 94 30All countries 531 690 70 953 133 646 13 566 32

When cells are left empty the data are unavailable and therefore could not be used for the calculation of the summary data

DM diabetes mellitus as cause of renal failureaPatients younger than 20 years of age are not reported The true incidence counts are therefore slightly higher than the counts reported herebData on incidence include dialysis patients onlycData on incidence of cause of renal failure (DM) include dialysis patients onlydData on incidence of cause of renal failure (DM) are based on 2836 of 11 447 patients (248)

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pmp) and French- and Dutch-speaking Belgium (1250 pmp and1238 pmp respectively Table 2 and Figures 5 and 6) The un-adjusted prevalence of RRT was considerably lower in theUkraine (157 pmp) and Albania (374 pmp) Of the prevalent pa-tients the majority were men (60) however now just underhalf were aged65 years (44) and a fifth had diabetes mellitus(19) as their primary renal diagnosis (Figure 7) The mean ageof the prevalent patients receiving RRT in all countries and re-gions combined was 609 years (Table 2) This ranged from amean age of 514 years in Albania to 664 years in Portugal Themajority of prevalent patients were receiving haemodialysis(57) just over a third of patients were living with a kidneytransplant (37) and only 5 were receiving peritoneal dialysis(Figure 8) Once again the modality of RRT varied considerably

between age groups as the age of the prevalent patientsincreased the proportion living with a kidney transplantdecreased For those aged 20ndash44 years 65 were living with akidney transplant whereas this was only 40 of patients aged65ndash74 years Again prevalent patients with a primary renal diag-nosis of diabetes mellitus were much less likely to be livingwith a kidney transplant compared with the non-diabetic group(28 versus 49)

Kidney transplantation

In 2014 19 406 kidney transplantations were performed thatequated to an overall unadjusted transplant rate of 36 pmp(Figure 9) Again this figure varied considerably between

Fig 1 Unadjusted incident rates per million population by countryregion at day 1 in 2014 The incident rates for Bulgaria and the Czech Republic only include patients

receiving dialysis

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pmp) and French- and Dutch-speaking Belgium (1250 pmp and1238 pmp respectively Table 2 and Figures 5 and 6) The un-adjusted prevalence of RRT was considerably lower in theUkraine (157 pmp) and Albania (374 pmp) Of the prevalent pa-tients the majority were men (60) however now just underhalf were aged65 years (44) and a fifth had diabetes mellitus(19) as their primary renal diagnosis (Figure 7) The mean ageof the prevalent patients receiving RRT in all countries and re-gions combined was 609 years (Table 2) This ranged from amean age of 514 years in Albania to 664 years in Portugal Themajority of prevalent patients were receiving haemodialysis(57) just over a third of patients were living with a kidneytransplant (37) and only 5 were receiving peritoneal dialysis(Figure 8) Once again the modality of RRT varied considerably

between age groups as the age of the prevalent patientsincreased the proportion living with a kidney transplantdecreased For those aged 20ndash44 years 65 were living with akidney transplant whereas this was only 40 of patients aged65ndash74 years Again prevalent patients with a primary renal diag-nosis of diabetes mellitus were much less likely to be livingwith a kidney transplant compared with the non-diabetic group(28 versus 49)

Kidney transplantation

In 2014 19 406 kidney transplantations were performed thatequated to an overall unadjusted transplant rate of 36 pmp(Figure 9) Again this figure varied considerably between

Fig 1 Unadjusted incident rates per million population by countryregion at day 1 in 2014 The incident rates for Bulgaria and the Czech Republic only include patients

receiving dialysis

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countries with the highest unadjusted transplant rates seen inthe Netherlands (59 pmp) Spain (57 pmp) and Norway (53 pmp)with some Spanish regions reaching even higher ratesConversely the lowest unadjusted transplant rates were re-ported in the Ukraine (2 pmp) Georgia (6 pmp) and Bulgaria (7pmp) Overall the unadjusted deceased donor transplant ratewas more than double that of the unadjusted living donortransplant rate (27 pmp versus 12 pmp Figure 10 68 versus31 Figure 11) The highest unadjusted rates of deceased donortransplants were seen in Spain (48 pmp) Croatia (46 pmp) and

the Czech Republic (43 pmp Figure 10) whereas the highest un-adjusted rate of living donor transplants were seen in theNetherlands (31 pmp) Turkey (30 pmp) and Northern Ireland(28 pmp Figure 10)

Survival of patients receiving RRT

For patients commencing RRT in the period 2005ndash09 the 1- 2-and 5-year-adjusted patient survival probabilities on all RRTmodalities were 900 [95 confidence interval (CI) 899ndash902]

Fig 2 Unadjusted (left panel) and adjusted (right panel) incident rates per million population by countryregion at day 1 in 2014 Registries providing individual patient

data are shown as dark bars and registries providing aggregated data as light bars The incident rate for Bulgaria and the Czech Republic only includes patients receiv-

ing dialysis

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828 (95 CI 826ndash830) and 633 (95 CI 630ndash636) respect-ively (see Appendix 2 and Table 3 for a description of the adjust-ments made and the countriesregions included in thisanalysis) For the same cohort of patients commencing dialysisbetween 2005 and 2009 the 1- 2- and 5-year-adjusted patientsurvival probabilities (with kidney transplantation consideredas a censored event) were 881 (95 CI 879ndash882) 795 (95CI 792ndash797) and 557 (95 CI 553ndash561) respectively Patientsurvival after a first kidney transplant performed during 2005and 2009 was much better than for those patients receiving dia-lysis (Figure 12) For those with a transplant 5-year-adjusted pa-tient and graft survival remain higher with a living donortransplant compared with a deceased donor transplant [957(95 CI 952ndash962) versus 923 (95 CI 919ndash927) for patient sur-vival and 870 (95 CI 863ndash878) versus 816 (95 CI 811ndash822) for graft survival See Appendix 2 and Table 3 for a descrip-tion of the adjustments made and the countriesregionsincluded in this analysis]

Expected remaining lifetime

There remains a substantial difference in the expected re-maining lifetime between the general population and thosereceiving dialysis (Figure 13) Patients aged 20ndash45 years old

Fig 3 Unadjusted incident percentages by (A) gender (B) age and (C) primary

renal diagnosis at day 1 in 2014 See Appendix 1 for a list of countries and re-

gions supplying individual patient level or aggregated level data

Fig 4 Unadjusted incident percentages of (A) established therapy overall and

established therapy by (B) gender (C) age and (D) primary renal diagnosis at day

91 in 2014 (B)ndash(D) are only based on data from registries providing individual pa-

tient data See Appendix 1 for a list of countries and regions supplying individ-

ual patient level or aggregated level data HD haemodialysis PD peritoneal

dialysis Tx transplant DM diabetes mellitus

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Table 2 Prevalence of RRT on 31 December 2014 for all primary renal diseases combined and diabetes mellitus types 1 and 2 by count (N) andunadjusted rate per million population and for all primary renal diseases combined the mean age of prevalent patients presented by coun-tryregion

General population coveredby the registry in thousands

Prevalent patients on RRT in 2014

Total N Total pmp Mean age DM N DM pmp

Albania 2863 1072 374 514 120 42Austria 8508 9038 1062 608 1791 211Belgium Dutch-speakinga 6444 7980 1238 655 1379 214Belgium French-speakinga 4788 5983 1250 646 1035 216Bosnia and Herzegovina 3508 2662 759 594 501 143Bulgaria 7217 4168 578Croatia 4070 4295 1055 646 1246 306Cyprus 847Czech Republic 10 222 10 931 1069Denmark 5700 5164 906 584 869 153Estonia 1315 834 634 578 155 118Finland 5462 4571 837 588 1167 214France 66 262 80 144 1210 622 12 604 190Georgia 4491 2096 467 561 435 97Greece 10 892 13 101 1203 638 2399 220Iceland 327 221 675 560 24 73Israelb 8216 6286 765 609 2909 354Italy (6 of 20 regions) 21 274 24 721 1162 618 2941 138Latvia 1590 996 627 557 97 61Lithuania 2943 2146 729Macedonia 2022 1543 763 569 225 111Montenegroa 622 296 476 524 47 76Norway 5137 4716 918 591 628 122Poland 36 338 31 106 856Portugalc 10 427 18 703 1794 664 3332 320Romaniad 19 710 17 620 894 599 1897 96Serbia 7131 5860 822 583 936 131Slovakiab 5421 3273 604 627 1067 197Spain 46 771 55 062 1177 595 7630 163Spain Andalusia 8394 9537 1136 600 1427 170Spain Aragon 1329 1524 1147 625 268 202Spain Asturias 1059 1228 1160 624 201 190Spain Basque country 2166 2571 1187 615 264 122Spain Cantabriaa 587 601 1025 610 85 145Spain Castile and Leona 2487 2696 1084 638 467 188Spain Castile-La Manchaa 2069 2180 1054 616 335 162Spain Catalonia 7519 9863 1312 623 1410 188Spain Extremadura 1100 1221 1110 614 191 174Spain Galicia 2741 3468 1265 619 600 219Spain Community of Madrid 6454 6739 1044 614 1183 183Spain Region of Murcia 1467 1845 1258 617 251 171Spain Navarrea 636 714 1122 619 79 124Spain Valencian region 5005 6495 1298 627 853 170Sweden 9696 9263 955 595 1641 169Switzerlandb 8230 2834 344 681 540 66The Netherlands 16 865 16 311 967 599 1991 118Tunisia Sfax regionb 1186 806 678 582 140 118Turkeye 77 696 71 318 918 2821 36Ukraine 42 903 6742 157 902 21UK Englanda 54 317 49 698 915 584 8043 148UK Northern Irelanda 1840 1598 868 582 243 132UK Scotland 5348 4757 890 565 724 135UK Walesa 3092 2828 915 595 483 156All countries 531 690 490 743 924 609 62 962 155

When cells are left empty the data are unavailable and therefore could not be used for the calculation of the summary data

DM diabetes mellitus as cause of renal failureaPatients younger than 20 years of age are not reported The true prevalent counts are therefore slightly higher than the counts reported herebData on prevalence include dialysis patients onlycData on prevalence of cause of renal failure (DM) include dialysis patients onlydThe overall prevalence of RRT is underestimated by approximately 3 due to an estimated 30 underreporting of patients living on a functioning grafteData on the prevalence of cause of renal failure (DM) are based on 8897 of 71 318 patients (125)

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receiving dialysis are expected to live only one-third as longas the age-matched general population The prospect is evenworse for patients aged 55ndash64 years as they are expected tolive only a quarter as long as their age-matched counterpartsin the general population Patients living with a kidney

transplant fare better than their counterparts receivingdialysis However for the transplant recipients aged 20ndash49years their life expectancy is still approximately one-thirdless than that of the age-matched general population As theage of the transplant recipient increases the disparity in life

Fig 5 Unadjusted prevalence per million population by countryregion on 31 December 2014 The prevalence rates for Israel Slovakia Switzerland and Tunisia (Sfax

region) only include patients receiving dialysis For Romania the overall prevalence of RRT is underestimated by 3 due to an estimated 30 underreporting of pa-

tients living on a functioning graft

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receiving dialysis are expected to live only one-third as longas the age-matched general population The prospect is evenworse for patients aged 55ndash64 years as they are expected tolive only a quarter as long as their age-matched counterpartsin the general population Patients living with a kidney

transplant fare better than their counterparts receivingdialysis However for the transplant recipients aged 20ndash49years their life expectancy is still approximately one-thirdless than that of the age-matched general population As theage of the transplant recipient increases the disparity in life

Fig 5 Unadjusted prevalence per million population by countryregion on 31 December 2014 The prevalence rates for Israel Slovakia Switzerland and Tunisia (Sfax

region) only include patients receiving dialysis For Romania the overall prevalence of RRT is underestimated by 3 due to an estimated 30 underreporting of pa-

tients living on a functioning graft

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expectancy with the age-matched general population alsoincreases

Affiliated registries

Albanian Renal Registry (M Barbullushi A Koroshi and all teamof Nephrology) Austrian Dialysis and Transplant Registry(OEDTR) (RK) Dutch-speaking Belgian Society of Nephrology(NBVN) (B De Moor F Schroven and J De Meester) French-speaking Belgian Society of Nephrology (GNFB) (JMdG and FCollart) Renal Registry Bosnia and Herzegovina (HR L Lukicand S Coric) Bulgaria (ESV I Velinova and M Gitcheva)Croatian Registry of Renal Replacement Therapy (CRRRT) (IB S

Racki and N Jankovic) Cyprus Renal Registry (KI and all of therenal units providing data) Czech Republic Registry of DialysisPatients (RDP) (I Rychlık J Potucek and FL) DanishNephrology Registry (DNS) (JGH) Estonian Society ofNephrology (euroU Pechter MR and K Lilienthal) Finnish Registryfor Kidney Diseases (PF and C Gronhagen-Riska) France TheEpidemiology and Information Network in Nephrology (REIN)(ML and C Couchoud) Georgian Renal Registry (NK andDialysis Nephrology and Transplantation Union of Georgia)Hellenic Renal Registry (NA) Icelandic End-Stage RenalDisease Registry (RP) Israel National Registry of RenalReplacement Therapy (R Dichtiar T Shohat and EG) ItalianRegistry of Dialysis and Transplantation (RIDT) (MN M

Fig 6 Unadjusted (left panel) and adjusted (right panel) prevalence per million population by countryregion on 31 December 2014 Registries providing individual pa-

tient data are shown as dark bars and registries providing aggregated data as light bars The prevalence rates for Israel Slovakia Switzerland and Tunisia (Sfax region)

only include patients receiving dialysis For Romania the overall prevalence of RRT is underestimated by 3 due to an estimated 30 underreporting of patients living

on a functioning graft

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Postorino and A Limido) Latvian Renal Registry (HC and VKuzema) Lithuanian Renal Registry (V Kuzminskis IABumblyt _e and EZ) Macedonian Renal Registry (L TrpenovskiZ Seljami and OS-T) Montenegrin Renal Registry (MR DRadunovic and V Prelevic) Norwegian Renal Registry (TLeivestad AV Reisaeligter and AA) Polish Renal Registry (BR MKlinger and G Korejwo) Portuguese Renal Registry (FM FNolasco and R Filipe) Romanian Renal Registry (RRR) (GMircescu LG and E Podgoreanu) Renal Registry in Serbia(Working Group of Serbian RRT Registry and all of the Serbianrenal units) Slovakian Renal Registry (VS I Lajdova and MKarolyova) Spanish RRT National Registry at ONT SpanishRegional Registries and Spanish Society of Nephrology (SEN)and the regional registries of Andalusia (SICATA) (PCdlN)Aragon (JI Sanchez Miret and JM Abad Diez) Asturias (RAdlT JR Quiros and RERCA Working Group) Basque country

Fig 8 Unadjusted prevalent percentages of (A) established therapy overall and

established therapy by (B) gender (C) age and (D) primary renal diagnosis on 31

December 2014 (B)ndash(D) are only based on data from registries providing individ-

ual patient data See Appendix 1 for a list of countries and regions supplying in-

dividual patient level or aggregated level data HD haemodialysis PD

peritoneal dialysis Tx transplant DM diabetes mellitus

Fig 7 Unadjusted prevalent percentages by (A) gender (B) age and (C) primary

renal diagnosis on 31 December 2014 See Appendix 1 for a list of countries and

regions supplying individual patient level or aggregated level data

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Fig 9 Kidney transplants performed in 2014 as counts and per million population (unadjusted) by countryregion Registries providing individual patient data are

shown as dark bars and registries providing aggregated data as light bars Data based on patients aged 20 years in Dutch-speaking Belgium French-speaking

Belgium Montenegro the Spanish regions of Cantabria Castile and Leon Castile-La Mancha and Navarre and the UK England Northern Ireland and Wales The total

count for Austria is based on residents and non-residents For Romania the transplantation activity reflects 70 of the total transplantation activity in the country due

to an underreporting of pre-emptive transplantation

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(UNIPAR) (AM J Aranzabal M Rodrigo and I Moina) Cantabria(M Arias Rodrıguez and O Garcıa Ruiz) Castile and Leon (RGand C Fernandez-Renedo) Castile-La Mancha (G GutierrezAvila and IMA) Catalonia (RMRC) (E Arcos J Comas and JTort) Extremadura (JM Ramos Aceitero and MAGB) Galicia(EBC and J Sanchez-Iba~nez) Community of Madrid (MIAM)Renal Registry of the Region of Murcia (CSdP and I MarınSanchez) Navarre (MFSR J Manrique Escola and J ArteagaColoma) and the Valencian region (REMRENAL) (C AlberichMartı and MFA) Swedish Renal Registry (SNR) (KG PrutzMES M Evans S Schon L Beuroackman and M Segelmark) SwissDialysis Registry (P Ambuhl and R Winzeler) Dutch RenalRegistry (RENINE) (MHH and A Hemke) Tunisia Sfax region(D Zalila S Toumi and FJ) Registry of the Nephrology Dialysisand Transplantation in Turkey (TSNNR) (G Suleymanlar NSand K Ates) Ukrainian Renal Data System (URDS) (MK S

Fig 10 Unadjusted deceased donor (left panel) and living donor (right panel) kidney transplants per million population performed in 2014 by countryregion Registries

providing individual patient data are shown as dark bars and registries providing aggregated data as light bars Data based on patients aged 20 years in Dutch-speak-

ing Belgium French-speaking Belgium Montenegro the Spanish regions of Cantabria Castile and Leon Castile-La Mancha and Navarre and the UK England

Northern Ireland and Wales The total count for Austria is based on residents and non-residents For Romania the transplantation activity reflects 70 of the total

transplantation activity in the country due to an underreporting of pre-emptive transplantation

Fig 11 Percentage of kidney transplants performed in 2014 by kidney donor

type See Appendix 1 for a list of countries and regions supplying individual pa-

tient level or aggregated level data

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(UNIPAR) (AM J Aranzabal M Rodrigo and I Moina) Cantabria(M Arias Rodrıguez and O Garcıa Ruiz) Castile and Leon (RGand C Fernandez-Renedo) Castile-La Mancha (G GutierrezAvila and IMA) Catalonia (RMRC) (E Arcos J Comas and JTort) Extremadura (JM Ramos Aceitero and MAGB) Galicia(EBC and J Sanchez-Iba~nez) Community of Madrid (MIAM)Renal Registry of the Region of Murcia (CSdP and I MarınSanchez) Navarre (MFSR J Manrique Escola and J ArteagaColoma) and the Valencian region (REMRENAL) (C AlberichMartı and MFA) Swedish Renal Registry (SNR) (KG PrutzMES M Evans S Schon L Beuroackman and M Segelmark) SwissDialysis Registry (P Ambuhl and R Winzeler) Dutch RenalRegistry (RENINE) (MHH and A Hemke) Tunisia Sfax region(D Zalila S Toumi and FJ) Registry of the Nephrology Dialysisand Transplantation in Turkey (TSNNR) (G Suleymanlar NSand K Ates) Ukrainian Renal Data System (URDS) (MK S

Fig 10 Unadjusted deceased donor (left panel) and living donor (right panel) kidney transplants per million population performed in 2014 by countryregion Registries

providing individual patient data are shown as dark bars and registries providing aggregated data as light bars Data based on patients aged 20 years in Dutch-speak-

ing Belgium French-speaking Belgium Montenegro the Spanish regions of Cantabria Castile and Leon Castile-La Mancha and Navarre and the UK England

Northern Ireland and Wales The total count for Austria is based on residents and non-residents For Romania the transplantation activity reflects 70 of the total

transplantation activity in the country due to an underreporting of pre-emptive transplantation

Fig 11 Percentage of kidney transplants performed in 2014 by kidney donor

type See Appendix 1 for a list of countries and regions supplying individual pa-

tient level or aggregated level data

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Tab

le3

Th

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rviv

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ties

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the

day

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n

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Pati

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on

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0(7

18ndash

721

)49

4(4

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)83

8(8

36ndash

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7(7

35ndash

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dju

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902

)82

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26ndash

830

)63

3(6

30ndash

636

)90

6(9

04ndash

907

)83

8(8

36ndash

840

)Pa

tien

tsu

rviv

alo

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(wit

hki

dn

eytr

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lan

tati

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asa

cen

sore

do

bser

vati

on

)U

nad

just

ed81

7(8

15ndash

819

)69

7(6

95ndash

699

)41

5(4

13ndash

416

)82

7(8

26ndash

829

)71

3(7

11ndash

714

)A

dju

sted

a88

1(8

79ndash

882

)79

5(7

92ndash

797

)55

7(5

53ndash

561

)89

0(8

89ndash

892

)81

1(8

08ndash

813

)Pa

tien

tsu

rviv

alaf

ter

firs

tki

dn

eytr

ansp

lan

tati

on

(dec

ease

dd

on

or)

Un

adju

sted

961

(95

8ndash96

3)

942

(93

9ndash94

5)

879

(87

5ndash88

3)

964

(96

1ndash96

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944

(94

1ndash94

6)

Ad

just

edb

976

(97

4ndash97

8)

964

(96

2ndash96

6)

923

(91

9ndash92

7)

980

(97

8ndash98

1)

968

(96

6ndash97

0)

Gra

ftsu

rviv

alaf

ter

firs

tki

dn

eytr

ansp

lan

tati

on

(dec

ease

dd

on

or)

Un

adju

sted

909

(90

6ndash91

2)

881

(87

7ndash88

4)

790

(78

6ndash79

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912

(90

9ndash91

5)

883

(88

0ndash88

6)

Ad

just

edb

922

(91

8ndash92

5)

897

(89

3ndash90

1)

816

(81

1ndash82

2)

927

(92

4ndash93

0)

902

(89

8ndash90

6)

Pati

ent

surv

ival

afte

rfi

rst

kid

ney

tran

spla

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tio

n(l

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gd

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or)

Un

adju

sted

984

(98

1ndash98

7)

975

(97

1ndash97

8)

942

(93

7ndash94

7)

988

(98

6ndash99

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979

(97

6ndash98

2)

Ad

just

edb

988

(98

6ndash99

1)

982

(97

9ndash98

5)

957

(95

2ndash96

2)

992

(99

0ndash99

3)

986

(98

3ndash98

8)

Gra

ftsu

rviv

alaf

ter

firs

tki

dn

eytr

ansp

lan

tati

on

(liv

ing

do

no

r)U

nad

just

ed95

5(9

50ndash

959

)93

6(9

30ndash

941

)87

0(8

64ndash

877

)96

3(9

59ndash

966

)94

5(9

41ndash

949

)A

dju

sted

b95

5(9

50ndash

960

)93

7(9

31ndash

942

)87

0(8

63ndash

878

)96

3(9

60ndash

967

)94

6(9

42ndash

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)

Th

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(Du

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(Fre

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D

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he

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(all

cou

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aA

nal

yses

wer

ead

just

edu

sin

gfi

xed

valu

esa

ge(6

0ye

ars)

gen

der

(60

men

)an

dp

rim

ary

ren

ald

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se(2

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yper

ten

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riti

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use

s)

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Nikolaenko and O Dubyna) UK Renal Registry (UKRR) (all the staffof the UK Renal Registry and of the renal units submitting data)Scottish Renal Registry (SRR) (all of the Scottish renal units)

ERA-EDTA Registry committee members

A Wiecek Poland (ERA-EDTA President) ZM France(Chairman) FJC UK C Couchoud France M Evans SwedenPF Finland JW Groothoff the Netherlands J HarambatFrance JGH Denmark FJ Tunisia MarN Italy and IRychlik Czech Republic

ERA-EDTA Registry office staff

KJJ (Managing Director) MB (for the paediatric section) RCornet G Guggenheim AK MauN MP VSS and AJWeerstra

Conflict of interest statement

None declared

Acknowledgements

The ERA-EDTA Registry would like to thank the patients andstaff of all the dialysis and transplant units who have con-tributed data via their national and regional renal registriesIn addition we would like to thank the persons and organ-izations listed in the paragraph lsquoaffiliated registriesrsquo for theircontribution to the work of the ERA-EDTA Registry TheERA-EDTA Registry is funded by the European RenalAssociation ndash European Dialysis and Transplant Association(ERA-EDTA) This article was written by MP et al on behalfof the ERA-EDTA Registry which is an official body of theERA-EDTA

References1 ERA-EDTA Registry ERA-EDTA Registry Annual Report 2014

Amsterdam The Netherlands Academic Medical CenterDepartment of Medical Informatics 2016

2 Noordzij M Kramer A Abad Diez JM et al Renal replacementtherapy in Europe a summary of the 2011 ERA-EDTA RegistryAnnual Report Clin Kidney J 2014 7 227ndash238

3 Pippias M Stel VS Abad Diez JM et al Renal replacement ther-apy in Europe a summary of the 2012 ERA-EDTA RegistryAnnual Report Clin Kidney J 2015 8 248ndash261

4 Kramer A Pippias M Stel VS et al Renal replacement therapyin Europe a summary of the 2013 ERA-EDTA Registry Annual

Fig 13 Expected remaining lifetimes of the general population in 2013 and

2014 and of prevalent dialysis and transplant patients in 2013 and 2014 (in-

cludes mortality in the first 90 days) by age and gender This figure is based

on data from the following registries providing individual patient data

Austria Belgium (Dutch-speaking) Belgium (French-speaking) Bosnia and

Herzegovina Denmark Estonia Finland France Greece Iceland Norway

Spain (Andalusia) Spain (Aragon) Spain (Asturias) Spain (Basque country)

Spain (Cantabria) Spain (Castille and Leon) Spain (Castille-La Mancha) Spain

(Catalonia) Spain (Extremadura) Spain (Galicia) Spain (Community of

Madrid) Spain (Region of Murcia) Spain (Valencian region) Sweden the

Netherlands and the UK (all countries)

Fig 12 The 5-year adjusted survival probability of incident dialysis patients

(commencing RRT between 2005 and 2009) and patients receiving a first trans-

plant (between 2005 and 2009) from day 91 by modality adjusted for age gender

and primary renal diagnosis Survival on dialysis was examined using the Cox

regression method with transplantation as a censored event (see the ERA-EDTA

2014 Annual Report for the full methods) Analyses were adjusted using fixed

values age (60 years) gender (60 men) and primary renal diagnosis (20 dia-

betes mellitus 17 hypertensionrenal vascular disease 15 glomeruloneph-

ritis and 48 other causes) This figure is based on data from the following

registries providing individual patient data Austria Belgium (Dutch-speaking)

Belgium (French-speaking) Denmark Finland France Greece Iceland Norway

Spain (Andalusia) Spain (Aragon) Spain (Asturias) Spain (Basque country)

Spain (Cantabria) Spain (Castile and Leon) Spain (Castile-La Mancha) Spain

(Catalonia) Spain (Extremadura) Spain (Galicia) Spain (Valencian region)

Sweden the Netherlands and the UK (all countries)

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ational Library of Health Sciences user on 20 February 2019

Nikolaenko and O Dubyna) UK Renal Registry (UKRR) (all the staffof the UK Renal Registry and of the renal units submitting data)Scottish Renal Registry (SRR) (all of the Scottish renal units)

ERA-EDTA Registry committee members

A Wiecek Poland (ERA-EDTA President) ZM France(Chairman) FJC UK C Couchoud France M Evans SwedenPF Finland JW Groothoff the Netherlands J HarambatFrance JGH Denmark FJ Tunisia MarN Italy and IRychlik Czech Republic

ERA-EDTA Registry office staff

KJJ (Managing Director) MB (for the paediatric section) RCornet G Guggenheim AK MauN MP VSS and AJWeerstra

Conflict of interest statement

None declared

Acknowledgements

The ERA-EDTA Registry would like to thank the patients andstaff of all the dialysis and transplant units who have con-tributed data via their national and regional renal registriesIn addition we would like to thank the persons and organ-izations listed in the paragraph lsquoaffiliated registriesrsquo for theircontribution to the work of the ERA-EDTA Registry TheERA-EDTA Registry is funded by the European RenalAssociation ndash European Dialysis and Transplant Association(ERA-EDTA) This article was written by MP et al on behalfof the ERA-EDTA Registry which is an official body of theERA-EDTA

References1 ERA-EDTA Registry ERA-EDTA Registry Annual Report 2014

Amsterdam The Netherlands Academic Medical CenterDepartment of Medical Informatics 2016

2 Noordzij M Kramer A Abad Diez JM et al Renal replacementtherapy in Europe a summary of the 2011 ERA-EDTA RegistryAnnual Report Clin Kidney J 2014 7 227ndash238

3 Pippias M Stel VS Abad Diez JM et al Renal replacement ther-apy in Europe a summary of the 2012 ERA-EDTA RegistryAnnual Report Clin Kidney J 2015 8 248ndash261

4 Kramer A Pippias M Stel VS et al Renal replacement therapyin Europe a summary of the 2013 ERA-EDTA Registry Annual

Fig 13 Expected remaining lifetimes of the general population in 2013 and

2014 and of prevalent dialysis and transplant patients in 2013 and 2014 (in-

cludes mortality in the first 90 days) by age and gender This figure is based

on data from the following registries providing individual patient data

Austria Belgium (Dutch-speaking) Belgium (French-speaking) Bosnia and

Herzegovina Denmark Estonia Finland France Greece Iceland Norway

Spain (Andalusia) Spain (Aragon) Spain (Asturias) Spain (Basque country)

Spain (Cantabria) Spain (Castille and Leon) Spain (Castille-La Mancha) Spain

(Catalonia) Spain (Extremadura) Spain (Galicia) Spain (Community of

Madrid) Spain (Region of Murcia) Spain (Valencian region) Sweden the

Netherlands and the UK (all countries)

Fig 12 The 5-year adjusted survival probability of incident dialysis patients

(commencing RRT between 2005 and 2009) and patients receiving a first trans-

plant (between 2005 and 2009) from day 91 by modality adjusted for age gender

and primary renal diagnosis Survival on dialysis was examined using the Cox

regression method with transplantation as a censored event (see the ERA-EDTA

2014 Annual Report for the full methods) Analyses were adjusted using fixed

values age (60 years) gender (60 men) and primary renal diagnosis (20 dia-

betes mellitus 17 hypertensionrenal vascular disease 15 glomeruloneph-

ritis and 48 other causes) This figure is based on data from the following

registries providing individual patient data Austria Belgium (Dutch-speaking)

Belgium (French-speaking) Denmark Finland France Greece Iceland Norway

Spain (Andalusia) Spain (Aragon) Spain (Asturias) Spain (Basque country)

Spain (Cantabria) Spain (Castile and Leon) Spain (Castile-La Mancha) Spain

(Catalonia) Spain (Extremadura) Spain (Galicia) Spain (Valencian region)

Sweden the Netherlands and the UK (all countries)

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Report with a focus on diabetes mellitus Clin Kidney J 2016 9457ndash469

Appendix 1Countries or regions providing individual patient level data AustriaDutch-speaking Belgium French-speaking Belgium Bosnia andHerzegovina Denmark Estonia Finland France Greece IcelandMontenegro Norway Romania Serbia the Spanish regions ofAndalusia Aragon Asturias Basque country Cantabria Castileand Leon Castile-La Mancha Catalonia Extremadura GaliciaCommunity of Madrid Murcia Navarre and Valencian regionSweden the Netherlands UK (EnglandNorthern IrelandWales)and UK (Scotland)

Countries or regions providing aggregated patient level dataAlbania Bulgaria Croatia Cyprus Czech Republic GeorgiaIsrael Italy Latvia Lithuania Macedonia Poland PortugalSlovakia Spain Switzerland Tunisia (Sfax region) Turkey andUkraine

Appendix 2Analyses for patient survival on RRT and dialysis were adjustedusing the following fixed values age (60 years) gender (60 men)and primary renal diagnosis (20 diabetes mellitus 17 hyper-tensionrenal vascular disease 15 glomerulonephritis and 48other causes)

Analyses for patient and graft survival after a first kidneytransplant were adjusted using the following fixed values age(45 years) gender (60 men) and primary renal diagnosis (10diabetes mellitus 8 hypertensionrenal vascular disease 28glomerulonephritis and 54 other causes)

The survival analyses presented here were based on datafrom Austria Dutch- and French-speaking BelgiumDenmark Finland France Greece Iceland Norway theSpanish regions of Andalusia Aragon Asturias Basque coun-try Cantabria Castile and Leon Castile-La ManchaCatalonia Extremadura Galicia and Valencian regionSweden the Netherlands and the UK

A summary of the 2014 ERA-EDTA Registry Annual Report | 169

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• sfw135-TF1
• sfw135-TF2
• sfw135-TF3
• sfw135-TF4
• sfw135-TF5
• sfw135-TF6
• sfw135-TF7
• sfw135-TF8
• sfw135-TF9
• sfw135-TF10
• sfw135-TF11
• sfw135-TF12
• sfw135-TF13
• sfw135-TF14
• sfw135-TF15
• sfw135-TF16
• app1
• app2