Objectives: To evaluate incidence and prevalence of patients with end-stage renal disease (ESRD) treated with maintenance dialysis in the Ile de France district in 1998.
Methodology: Prospective epidemiologic inquiry with the cooperation of the 91 nephrology departments and dialysis facilities of the Ile de France district (total population: 10,695,300 inhabitants in March 1999), from January 1st to December 31st, 1998. Evaluation of the demographic and clinical characteristics of the 1155 patients accepted on maintenance dialysis in 1998, and recording of the total number of dialyzed patients at the beginning and at the end of the same year.
Results: The total number of ESRD patients was 1155, including 29 (2.5%) children aged < or = 17 years and 86 (7.4%) returns to dialysis following kidney graft failure. Incidence of ESRD in first-dialyzed patients was 100/million/year and overall incidence, including returns from transplantation, was 108/million/year. Mean age of the 1040 adult first-dialysis patients was 59 +/- 16.8 years, with a proportion of those aged > or = 75 years of 21.6%. Patients with vascular renal disease were 22.5% and those with diabetic nephropathy 20.6%. As a whole, 36.5% of patients were referred to the nephrologist < 6 months of starting dialysis. Prevalence of patients on supportive dialysis increased from 417 to 433 per million inhabitants (a 3.8% increase) from the beginning to the end of 1998, with the proportion of patients treated with self-care dialysis or peritoneal dialysis rising by 10%. From January 1995 to January 1999, prevalence of dialysis-treated ESRD patients rose by nearly 4% per year as a mean.
Conclusion: Incidence of ESRD patients requiring maintenance dialysis in the Ile de France district reached 100/million in 1998, an increment of 4% per year over the past 4 years. The increase in incidence results from the increasing number of older patients, parallel to the ageing of general population, these patients having a high comorbidity mainly due to diabetes and atherosclerosis. Prevalence of dialysis-treated patients was 433/million population at the end of 1998. It rose at a similar rate as did incidence, although with a growing proportion of out-center dialysis.