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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...

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Autores principales: Peters, Frederik, Westphal, Christina, Kramer, Anneke, Westerman, Ronny
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
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.
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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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