Renal replacement therapy in Europe: the results of a collaborative effortby the ERA-EDTA registry and six national or regional registries

Background. In June 2000 a new ERA-EDTA Registry Office was opened in Amste rdam. This Registry will only collect core data on renal replacement therap y (RRT) through national and regional registries. This paper reports the te chnical and epidemiological results of a pilot study combining the data fro m six registries. Methods. Data from the national renal registries of Austria, Finland, Frenc h-Belgium, The Netherlands, Norway, and Scotland were combined. Patients st arting RRT between 1980 and 1999 (n=57 371) were included in the analyses. Cox proportional hazards regression was used to predict survival. Results. The use of different coding systems for ESRD treatment by the regi stries made it difficult to merge the data. Incidence and prevalence of RRT showed a continuous increase with a marked variation in rates between coun tries. The 2-, 5- and 10-year patient survival was 57, 35 and 11%, in dialy sis patients and 90, 81 and 64% after a first renal allograft. Multivariate analysis showed a slightly better survival on dialysis in the 1990-1994 (R R 0.94. 95% CI 0.90-0.98) and the 1995-1999 cohort (RR 0.88, 95% CI 0.84-0. 92) compared to the 1980-1984 cohort. In contrast, there was a much greater improvement in transplant-patient survival, resulting in a 56% reduction i n the risk of death within the 1995-1999 cohort (RR 0.44, 95% CI 0.39-0.50) compared to the 1980-1984 cohort. Conclusions. This study provides support for the feasibility of a 'new styl e' ERA-EDTA registry and the collection of data is now being extended to ot her countries. The improvement in patient survival over the last two decade s has been much greater in transplant recipients than in dialysis patients.