Geographic, ethnic, age-related and temporal variation in the incidence of end-stage renal disease in Europe, Canada and the Asia-Pacific region, 1998-2002

Nephrol Dial Transplant. 2006 Aug;21(8):2178-83. doi: 10.1093/ndt/gfl145. Epub 2006 Apr 4.


Background: Only unbiased estimates of end-stage renal disease (ESRD) incidence and trends are useful for disease control-identification of risk factors and measuring the effect of intervention.

Methods: Age- and sex-standardized incidences (with trends) were calculated for all-cause and diabetic/non-diabetic ESRD for persons aged 0-14, 15-29, 30-44 and 45-64 years in 13 populations identified geographically, and six populations identified by ethnicity.

Results: The incidence of ESRD varied most with age, ethnicity and prevalence of diabetes. All non-Europid populations had excess ESRD, chiefly due to rates of type 2 diabetic ESRD that were greater than accounted for by community prevalences of diabetes. Their rates of non-diabetic ESRD also were raised, with contributions from most common primary renal diseases except type 1 diabetic nephropathy and polycystic kidney disease. The ESRD rates generally were low, and more similar than different, in Europid populations, except for variable contributions from type 1 (high in Finland, Sweden, Denmark and Canada) and type 2 (high in Austria and Canada) diabetes. In Europid populations during 1998-2002, all-cause ESRD declined by 2% per year in persons aged 0-44 years, and all non-diabetic ESRD by a similar amount in persons aged 45-64 years, in whom diabetic ESRD had increased by 3% per year.

Conclusions: Increased susceptibility to type 2 diabetes and to kidney disease progression characterizes excess ESRD in non-Europid peoples. The decline in all-cause ESRD in young persons, and non-diabetic ESRD in the middle-aged, probably reflects improving management of progressive renal disease.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / ethnology
  • Disease Progression
  • Disease Susceptibility
  • Europe / epidemiology
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / ethnology
  • Malaysia / epidemiology
  • Male
  • Micronesia / epidemiology
  • Middle Aged
  • New Zealand / epidemiology
  • Registries
  • Renal Replacement Therapy / statistics & numerical data
  • Time Factors