ESRD patient mortality with adjustment for comorbid conditions in Lombardy (Italy) versus the United States.
The present study evaluated end-stage renal disease (ESRD) patient survival in Lombardy, Italy, and the United States (U.S.) using data from two registries, the Lombardy Dialysis and Transplant Registry (RLDT) and the U.S. Renal Data System (USRDS), respectively.
For this purpose, 4,196 white patients (2,900 from the USRDS Case Mix Severity Study and all 1296 from RLDT) who started renal replacement therapy in 1986 and 1987 were studied.
Compared to Lombardy patients, those in the USA were significantly older (mean age 59.9 ± 16.4 vs. 55.9 ± 14.7 years), had a lower proportion of males (53.7 vs. 62.1%), a greater proportion with diabetic nephropathy (29.9 vs. 9.7%) and a significantly greater proportion of patients with the recorded comorbid conditions (heart disease, peripheral vascular disease, cirrhosis, cachexia, malignancy).
U.S. patients were less frequently treated with peritoneal dialysis (PD) by day 30 of ESRD (21.2 vs. 30.7).
Survival was compared in the Cox proportional hazard regression model, using age, sex, comorbid conditions and early modality of treatment as explanatory covariates.
Overall, 48% of the 4196 patients died during the 48 to 72 months follow-up to 12/31/91.
Per 100 patient-years the gross death rate for USRDS patients was 28.7 compared to 13.0 of RLDT patients.
The unadjusted death relative risk for RLDT was 0.439, that is, 56% lower death rate compared to USRDS patients. (...)
Mots-clés Pascal : Insuffisance rénale, Stade terminal, Homme, Pronostic, Survie, Mortalité, Lombardie, Italie, Europe, Etats Unis, Amérique du Nord, Amérique, Etude comparative, Epidémiologie, Echelon international, Appareil urinaire pathologie, Rein pathologie
Mots-clés Pascal anglais : Renal failure, Terminal stage, Human, Prognosis, Survival, Mortality, Lombardy, Italy, Europe, United States, North America, America, Comparative study, Epidemiology, International scope, Urinary system disease, Renal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0418811
Code Inist : 002B14A05. Création : 10/04/1997.