Incidence of end-stage renal disease in the Ile de France district: a prospective epidemiologic study

OBJECTIVES: To evaluate incidence and prevalence of patients with end-stage renal disease (ESRD) treated with maintenance dialysis in the lie de Franc e district in 1998. METHODOLOGY: Prospective epidemiologic inquiry with the cooperation of the 91 nephrology departments and dialysis facilities of the Ile de France dist rict (total population : 10,695,300 inhabitants in March 1999), from Januar y Ist to December 31st, 1998. Evaluation of the demographic and clinical ch aracteristics of the 1155 patients accepted on maintenance dialysis in 1998 , and recording of the total number of dialyzed patients at the beginning a nd at the end of the same year. RESULTS: The total number of ESRD patients was 1155, including 29 (2.5%) ch ildren aged less than or equal to 17 years and 86 (7.4%) returns to dialysi s following kidney graft failure. Incidence of ESRD in first-dialyzed patie nts was 100/million/year and overall incidence, including returns from tran splantation, was 108/million/year. Mean age of the 1040 adult first-dialysi s patients was 59 +/- 16.8 years, with a proportion of those aged greater t han or equal to 75 years of 21.6%. Patients with vascular renal disease wer e 22.5% and those with diabetic nephropathy 20.6%. As a whole, 36.5% of pat ients were referred to the nephrologist < 6 months of starting dialysis. Pr evalence of patients on supportive dialysis increased from 417 to 433 per m illion inhabitants (a 3.8% increase) from the beginning to the end of 1998, with the proportion of patients treated with self care dialysis or periton eal dialysis rising by 10%. From January 1995 to January 1999, prevalence o f dialysis-treated ESRD patients rose by nearly 4% per year as a mean. CONCLUSION: incidence of ESRD patients requiring maintenance dialysis in th e lie de France district reached 100/million in 1998, an increment of 4% pe r year over the past 4 years. The increase in incidence results from the in creasing number of older patients, parallel to the ageing of general popula tion, these patients having a high comorbidity mainly due to diabetes and a therosclerosis. Prevalence of dialysis-treated patients was 433/million pop ulation at the end of 1998. it rose at a similar rate as did incidence, alt hough with a growing proportion of our-center dialysis.