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Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer?
BACKGROUND: Renal replacement therapy (RRT) is one of the most expensive in renal medicine. Cross-sectional studies suggest that life expectancy increases in the general population are associated with a higher burden of RRT. This study tests this hypothesis in a prospective setting among people aged...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945809/ https://www.ncbi.nlm.nih.gov/pubmed/29780798 http://dx.doi.org/10.3389/fpubh.2018.00138 |
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author | Peters, Frederik Westphal, Christina Kramer, Anneke Westerman, Ronny |
author_facet | Peters, Frederik Westphal, Christina Kramer, Anneke Westerman, Ronny |
author_sort | Peters, Frederik |
collection | PubMed |
description | BACKGROUND: Renal replacement therapy (RRT) is one of the most expensive in renal medicine. Cross-sectional studies suggest that life expectancy increases in the general population are associated with a higher burden of RRT. This study tests this hypothesis in a prospective setting among people aged 75+ living in Western Europe. METHODS: We gathered sex-specific data for 11 Western European countries in 2005–2014. RRT prevalence on country level was extracted from the ERA-EDTA registry, while data on population size and life expectancy for the 75+ age group came from the Eurostat database. GDP per capita was extracted from the OECD database. To measure the association between RRT prevalence and life expectancy, we performed Poisson regression models separately for each country and for all countries combined. To adjust for confounding, GDP per capita as well as time and country-fixed effects were included. RESULTS: Our analysis revealed that living longer coincides with rising RRT prevalence at ages 75+ in Western Europe between 2005 and 2014. On average, a 1-year increase in life expectancy was associated with a roughly 20% increase in RRT prevalence [(95% CI) 21–23% in men and 19–22% in women]. However, after adjustments for confounding were made, the association became insignificant among women and became weaker among men, falling to a level of 11% [(95% CI) 6–17%]. CONCLUSION: Living longer was not necessarily associated with a higher burden of RRT in Western European countries. |
format | Online Article Text |
id | pubmed-5945809 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-59458092018-05-18 Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? Peters, Frederik Westphal, Christina Kramer, Anneke Westerman, Ronny Front Public Health Public Health BACKGROUND: Renal replacement therapy (RRT) is one of the most expensive in renal medicine. Cross-sectional studies suggest that life expectancy increases in the general population are associated with a higher burden of RRT. This study tests this hypothesis in a prospective setting among people aged 75+ living in Western Europe. METHODS: We gathered sex-specific data for 11 Western European countries in 2005–2014. RRT prevalence on country level was extracted from the ERA-EDTA registry, while data on population size and life expectancy for the 75+ age group came from the Eurostat database. GDP per capita was extracted from the OECD database. To measure the association between RRT prevalence and life expectancy, we performed Poisson regression models separately for each country and for all countries combined. To adjust for confounding, GDP per capita as well as time and country-fixed effects were included. RESULTS: Our analysis revealed that living longer coincides with rising RRT prevalence at ages 75+ in Western Europe between 2005 and 2014. On average, a 1-year increase in life expectancy was associated with a roughly 20% increase in RRT prevalence [(95% CI) 21–23% in men and 19–22% in women]. However, after adjustments for confounding were made, the association became insignificant among women and became weaker among men, falling to a level of 11% [(95% CI) 6–17%]. CONCLUSION: Living longer was not necessarily associated with a higher burden of RRT in Western European countries. Frontiers Media S.A. 2018-05-04 /pmc/articles/PMC5945809/ /pubmed/29780798 http://dx.doi.org/10.3389/fpubh.2018.00138 Text en Copyright © 2018 Peters, Westphal, Kramer and Westerman. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Peters, Frederik Westphal, Christina Kramer, Anneke Westerman, Ronny Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? |
title | Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? |
title_full | Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? |
title_fullStr | Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? |
title_full_unstemmed | Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? |
title_short | Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer? |
title_sort | is the rise in the prevalence of renal replacement therapy at older ages the price for living longer? |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945809/ https://www.ncbi.nlm.nih.gov/pubmed/29780798 http://dx.doi.org/10.3389/fpubh.2018.00138 |
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