Articles producció científica> Ciències Mèdiques Bàsiques

Maps of systematic variation in renal replacement therapy in Catalonia (2002-2012) [Atlas de variaciones sistemáticas en el tratamiento sustitutivo renal en Cataluña (2002-2012)]

  • Datos identificativos

    Identificador: PC:2643
    Handle: https://hdl.handle.net/20.500.11797/PC2643
    Autores:
    Tebé Condomí, C.Arcos, E.Comas, J.Espallargues, M.Pons, J.M.V.Díaz, J.M.Tort, J.Martinez-Castelao, A.
    Resumen:
    Introduction Variations in the use of healthcare services can be defined as systematic variations of adjusted rates for certain aggregation levels of the population. The study analyses how renal replacement therapy (RRT) is used, identifying RRT variability in Catalonia from 2002 to 2012. Material and methods Ecological study by health area using data from the Catalan renal registry. We present incident rates, standardised incidence ratios and prevalence, while variability was calculated through direct and indirect standardisation methods. Results From 2002 until 31/12/2012, 10,784 patients initiated RRT in Catalonia: 9,238 on haemodialysis (HD) (50 treatments per 100,000 people 2010/2012), 1,076 on peritoneal dialysis (PD) (8.2 treatments per 100,000 people 2010/2012) and 470 received an early kidney transplant (KT) (4.4 treatments per 100,000 people 2010/2012). Over the 10 years, the HD cumulative incidence rate fell (7%), while the PD and KT incidence rates increased (63% and 177%, respectively); both are higher in young patients (<45 years). 4,750 patients received a kidney transplant in this period, 49% of which were aged between 45 and 65 years. There were no significant differences in variability in HD (RV5-95 = 1.3; Empirical Bayes [EB]∼ 0), or in the prevalence of KT (RV5-95 = 1.4; EB ∼ 0). Nevertheless, we found significant geographical variability in PD; notably in the districts of the province of Lérida, where the number of cases observed was greater than expected (RV5-95 = 4.01; EB = 0.08). Conclusion Although there was a notable rise in PD and early KT incidence rates, PD is still underused when compared to international recommendations. No territorial variability was found for HD or KT, but the use of PD was found to be higher in Lérida than in other area

  • Otros:

    Autor según el artículo: Tebé Condomí, C.; Arcos, E.; Comas, J.; Espallargues, M.; Pons, J.M.V.; Díaz, J.M.; Tort, J.; Martinez-Castelao, A.
    Departamento: Ciències Mèdiques Bàsiques
    Autor/es de la URV: TEBÉ CORDOMÍ, CRISTIAN; Arcos, E.; Comas, J.; Espallargues, M.; Pons, J.M.V.; Díaz, J.M.; Tort, J.; Martinez-Castelao, A.
    Palabras clave: Renal replacement therapy Peritoneal dialysis Kidney transplantation
    Resumen: Introduction Variations in the use of healthcare services can be defined as systematic variations of adjusted rates for certain aggregation levels of the population. The study analyses how renal replacement therapy (RRT) is used, identifying RRT variability in Catalonia from 2002 to 2012. Material and methods Ecological study by health area using data from the Catalan renal registry. We present incident rates, standardised incidence ratios and prevalence, while variability was calculated through direct and indirect standardisation methods. Results From 2002 until 31/12/2012, 10,784 patients initiated RRT in Catalonia: 9,238 on haemodialysis (HD) (50 treatments per 100,000 people 2010/2012), 1,076 on peritoneal dialysis (PD) (8.2 treatments per 100,000 people 2010/2012) and 470 received an early kidney transplant (KT) (4.4 treatments per 100,000 people 2010/2012). Over the 10 years, the HD cumulative incidence rate fell (7%), while the PD and KT incidence rates increased (63% and 177%, respectively); both are higher in young patients (<45 years). 4,750 patients received a kidney transplant in this period, 49% of which were aged between 45 and 65 years. There were no significant differences in variability in HD (RV5-95 = 1.3; Empirical Bayes [EB]∼ 0), or in the prevalence of KT (RV5-95 = 1.4; EB ∼ 0). Nevertheless, we found significant geographical variability in PD; notably in the districts of the province of Lérida, where the number of cases observed was greater than expected (RV5-95 = 4.01; EB = 0.08). Conclusion Although there was a notable rise in PD and early KT incidence rates, PD is still underused when compared to international recommendations. No territorial variability was found for HD or KT, but the use of PD was found to be higher in Lérida than in other areas. To reduce PD territorial variability and increase the uptake of this technique in the other regions, we propose 3 initiatives: The development of RRT support tools for shared decision-making, the encouragement of specific PD professional training and the promotion of PD through complementary reimbursement systems.
    Áreas temáticas: Biochemistry and technology Bioquímica y tecnología Bioquímica i biotecnologia
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 0211-6995
    Identificador del autor: orcid.org/0000-0003-2320-1385; N/D; N/D; N/D; N/D; N/D; N/D; N/D
    Fecha de alta del registro: 2017-05-03
    Página final: 171
    Volumen de revista: 37
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://www.sciencedirect.com/science/article/pii/S0211699516301175?via%3Dihub
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    DOI del artículo: 10.1016/j.nefro.2016.08.003
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2017
    Página inicial: 164
    Tipo de publicación: Article Artículo Article

  • Palabras clave:

    Hemodiàlisi
    Diàlisi peritoneal
    Ronyons -- Trasplantació
    Renal replacement therapy
    Peritoneal dialysis
    Kidney transplantation
    Biochemistry and technology
    Bioquímica y tecnología
    Bioquímica i biotecnologia
    0211-6995

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