EVALUATION OF INCIDENCE OF ACUTE-RENAL-FA ILURE AND CHOICE OF RENAL REPLACEMENT THERAPY STRATEGIES

Due to lack of structured epidemiological studies, the incidence of ac ute renal failure (ARF) cannot be established in France. An empirical approach method based on answered questionaire sent by mail to nephrol ogy centers affiliated or not to universities has been used to estimat e the frequency of ARF requiring dialysis in 1991. We postulated that the French population was homogenously distributed among the different regions and that the response rate of 74% could be extrapolated to 10 0%. We could therefore calculate an incidence of 64 ARF per million of inhabitants. However, this underestimates the exact incidence since t he acurate evaluation of IRA in a controled region (Champagne-Ardenne) is 104 per million of inhabitants. In addition, this study underlines the fact that many ARF are not treated in nephrology units, especiall y those associated with multiorgan failure requiring slow continuous h emofiltration and hemodialysis. It is suggested that the establishment of a national Registry for ARF and an adequate training of nephrologi sts are prerequisites to assess epidemiology and the global cost of AR F.