Interpreting incidence trends for treated end-stage renal disease: implications for evaluating disease control in Australia

Nephrology
John H StewartStephen P McDonald

Abstract

Five sources of change modify trends in incidence of treated end-stage renal disease (ESRD): (i) demography; (ii) disease control, comprising prevention and treatment of progressive kidney disease; (iii) competing risks, which encompass dying from untreated uraemia or non-renal comorbidity; (iv) lead-time bias; and (v) classification bias. Thus, rising crude incidence of treated ESRD may conceal effective disease control when there has been demographic change, lessening competing risks, or the introduction of bias. Age-specific incidences of treated ESRD in Australia were calculated from Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry data by indigenous/non-indigenous status (all causes) and by primary renal disease (non-indigenous only) for two successive decades, 1982-1991 and 1992-2001. We postulate that less competing risks explained much of the increase in treated ESRD in the elderly and Indigenous Australians. The increase in glomerulonephritic ESRD in non-indigenous Australians could be ascribed mainly to immigration from non-European countries. There was no significant change in incidence of treated ESRD in Indigenous or non-indigenous persons aged less than 25 years, in non-indigenous persons aged ...Continue Reading

References

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Citations

May 19, 2005·Analytical and Bioanalytical Chemistry·Johannes PillNorbert Gretz
Feb 19, 2005·Advances in Chronic Kidney Disease·Stephen McDonaldJohn Stewart
Feb 19, 2005·Advances in Chronic Kidney Disease·Stephen P McDonald, Wendy E Hoy
Apr 11, 2007·Current Opinion in Nephrology and Hypertension·Chi-yuan Hsu
Apr 15, 2008·Current Opinion in Nephrology and Hypertension·Stein Ivar Hallan, Bjørn Egil Vikse
Feb 19, 2010·Current Opinion in Nephrology and Hypertension·Robert N Foley
Dec 1, 1994·Australian and New Zealand Journal of Medicine·J H StewartT H Mathew
Feb 15, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Sean Haw ChangStephen Peter McDonald
Aug 6, 2014·Nature Reviews. Nephrology·Stephen McDonald, Gopala Rangan
Sep 4, 2008·Expert Opinion on Emerging Drugs·Su-Yen GohMark E Cooper
Feb 26, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Emilie CounilHichem Trimech
Nov 28, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Claire SparkeStephen McDonald
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