The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France

Couchoud, Cécile; Stengel, Bénédicte; Landais, Paul; Aldigier, Jean-Claude; Cornelissen, F. De; Dabot, Christian; Maheut, Hervé; Joyeux, V.; Kessler, Michèle; Labeeuw, M; Isnard, H.; Jacquelinet, Christian

doi:10.1093/ndt/gfi198

Cited by 237 publications

(174 citation statements)

References 15 publications

Supporting

Mentioning

169

Contrasting

Unclassified

Order By: Relevance

“…The percentage of diabetic nephropathy in our study was low, 13%. This is likely to reflect a combination of low prevalence of the disease in the Paris area (18% of the prevalent ESRD population has diabetic nephropathy) 42 and the later referral to nephrologists, commonly at stage 5, of patients with diabetes compared with other patients with CKD, as well as recruitment bias from university hospitals. This may result in underestimating the prevalence of anemia, given its link with diabetic kidney disease.…”

Section: Discussionmentioning

confidence: 99%

Timing of Onset of CKD-Related Metabolic Complications

Moranne

Froissart²,

Rossert³

et al. 2009

Journal of the American Society of Nephrology

419

283

View full text Add to dashboard Cite

Chronic kidney disease (CKD) guidelines recommend evaluating patients with GFR Ͻ60 ml/min per 1.73 m 2 for complications, but little evidence supports the use of a single GFR threshold for all metabolic disorders. We used data from the NephroTest cohort, including 1038 adult patients who had stages 2 through 5 CKD and were not on dialysis, to study the occurrence of metabolic complications. GFR was measured using renal clearance of 51 Cr-EDTA (mGFR) and estimated using two equations derived from the Modification of Diet in Renal Disease study. As mGFR decreased from 60 to 90 to Ͻ20 ml/min per 1.73 m 2 , the prevalence of hyperparathyroidism increased from 17 to 85%, anemia from 8 to 41%, hyperphosphatemia from 1 to 30%, metabolic acidosis from 2 to 39%, and hyperkalemia from 2 to 42%. Factors most strongly associated with metabolic complications, independent of mGFR, were younger age for acidosis and hyperphosphatemia, presence of diabetes for acidosis, diabetic kidney disease for anemia, and both male gender and the use of inhibitors of the renin-angiotensin system for hyperkalemia. mGFR thresholds for detecting complications with 90% sensitivity were 50, 44, 40, 39, and 37 ml/min per 1.73 m 2 for hyperparathyroidism, anemia, acidosis, hyperkalemia, and hyperphosphatemia, respectively. Analysis using estimated GFR produced similar results. In summary, this study describes the onset of CKD-related complications at different levels of GFR; anemia and hyperparathyroidism occur earlier than acidosis, hyperkalemia, and hyperphosphatemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Timing of Onset of CKD-Related Metabolic Complications

Moranne

Froissart²,

Rossert³

et al. 2009

Journal of the American Society of Nephrology

419

283

View full text Add to dashboard Cite

show abstract

“…The REIN was founded in 2001 as a tool to provide public health decision support, evaluation, and research related to RRT for ESRD (15). Data are collected at the initiation of RRT (i.e., hemodialysis [HD], peritoneal dialysis, or kidney transplantation [KTR]) for all patients in France and updated annually.…”

Section: Materials and Methods Patient Population Data Collection Amentioning

confidence: 99%

Trends in Survival and Renal Recovery in Patients with Multiple Myeloma or Light-Chain Amyloidosis on Chronic Dialysis

Decourt¹,

Gondouin²,

Delaroziere

et al. 2016

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives Monoclonal gammopathies (MGs) with renal involvement can lead to ESRD caused by myeloma cast nephropathy (MCN), immunoglobulin light chain amyloidosis (ALA), or light-chain deposition disease (LCDD). Few studies have focused on the prognosis of patients with MG on chronic dialysis. We evaluated the outcomes of patients with MG incident on chronic dialysis in France.Design, setting, participants, & measurements All incident patients registered in the Renal Epidemiology and Information Network Registry between 2002 and 2011 with ESRD caused by ALA, LCDD, or MCN were included. Patient's survival, censored for renal transplantation, renal recovery, and loss to follow-up, as well as renal outcomes were analyzed and compared with a control group. Risk factors and causes of death were analyzed.Results We included 1459 patients, comprising 265 (18%) patients with ALA, 334 (23%) patients with LCDD, and 861 (59%) patients with MCN. Median age was 72 years, and 56% were men. Median follow-up was 13.1 months. Renal recovery was observed in 9.1% of patients and more frequent after 2006. Kidney transplantation was rare in this population (2.3%). Among 1272 patients who remained on dialysis, 67% died. Median survival on dialysis was 18.3 months. Main causes of death were malignancies (34.4%), cardiovascular diseases (18%), infections (13.3%), and cachexia (5.2%). Independent risk factors of death were age (hazard ratio [HR], 1.03 per year increase; 95% confidence interval [95% CI], 1.02 to 1.03), frailty (HR, 1.93; 95% CI, 1.58 to 2.36), congestive heart failure (HR, 1.54; 95% CI, 1.23 to 1.93), and dialysis initiation on a central catheter (HR, 1.40; 95% CI, 1.11 to 1.75). Factors associated with a lower risk of death were year of dialysis initiation (HR, 0.95 per year increase; 95% CI, 0.91 to 0.99) and high BP (HR, 0.80; 95% CI, 0.67 to 0.97).Conclusions Survival of patients with ALA, LCDD, or MCN on chronic dialysis is poor but has improved over time. Progressive malignancy is the main cause of death in this population. Renal recovery has increased since 2006.

show abstract

“…REIN is used as a decision support system for public health policy-making, evaluation, and epidemiological research related to ESRD in France. In 2002, it began recording data about ESRD patients treated by dialysis or KTx (36,37) in each administrative region where all hospitals and dialysis centers treating ESRD agreed to participate. As agreements increased, the registry progressively included more regions and finally reached complete national coverage (France and overseas) in 2011 ( Figure 1): 26 administrative regions and 64 million inhabitants.…”

Section: Rein Registrymentioning

confidence: 99%

Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

Bayat

Macher

Couchoud

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

Several studies have investigated geographical variations in access to renal transplant waiting lists, but none has assessed the impact on these variations of factors at both the patient and geographic levels. The objective of our study was to identify medical and nonmedical factors at both these levels associated with these geographical variations in waiting-list placement in France. We included all incident patients aged 18-80 years in 11 French regions who started dialysis between January 1, 2006, and December 31, 2008. Both a multilevel Cox model with shared frailty and a competing risks model were used for the analyses. At the patient level, old age, comorbidities, diabetic nephropathy, non-autonomous first dialysis, and female gender were the major determinants of a lower probability of being waitlisted. At the regional level, the only factor associated with this probability was an increase in the number of patients on the waiting list from 2005 to 2009. This finding supports a slight but significant impact of a regional organ shortage on waitlisting practices. Our findings demonstrate that patients' age has a major impact on waitlisting practices, even for patients with no comorbidity or disability, whose survival would likely be improved by transplantation compared with dialysis.

show abstract

The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France

Cited by 237 publications

References 15 publications

Timing of Onset of CKD-Related Metabolic Complications

Timing of Onset of CKD-Related Metabolic Complications

Trends in Survival and Renal Recovery in Patients with Multiple Myeloma or Light-Chain Amyloidosis on Chronic Dialysis

Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

Contact Info

Product

Resources

About