RENAL REPLACEMENT THERAPY IN CANADA - A REPORT FROM THE CANADIAN ORGAN REPLACEMENT REGISTER

We report here the demography and results of renal replacement therapy in Canada from 1981 to 1992. The new case rate for patients entering renal replacement therapy programs in Canada has increased dramaticall y over the last 12 years, from 49.9 per million to 98.4 per million of the population. The largest increases have been among the elderly, fr om 146.2 per million in 1981 to 381.9 per million in 1992 for those ag ed 65 to 74 years. There has been an even more dramatic increase for t hose over 75 years, from 83.6 per million in 1981 to 261.6 per million in 1992. There has been a similar increase in the prevalence rate, wi th an increase from 229.1 per million in 1981 to 518.5 per million in 1992. The hemodialysis rate for 1992 was 172.2 per million and that fo r peritoneal dialysis was 103.1 per million of the population. The ren al transplantation rate also increased from 20 per million in 1981 to 34.8 per million in 1988, but unfortunately has decreased to 27.5 per million in 1992. Diabetes is now the most common primary renal diagnos is, having increased from 15% in 1981 to 24% in 1992. The 5-year survi val rate of all patients on renal replacement therapy was 55%. For non diabetic patients, the 5-year survival rate ranged from 85% for the th ose aged 15 to 44 years to 20% for those over 65 years. Among diabetic patients, the 5-year survival rate declined from 58% for the 15 to 44 year age group to 10% for those over 65 years. (C) 1995 by the Nation al Kidney Foundation, Inc