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CONNEXI 2015-05 Nephrologie Dialyse Transplantation

  • Text
  • Patienten
  • Therapie
  • Conferences
  • Peritoneal
  • Dialysis
  • Studie
  • Studien
  • Dialysepatienten
  • Dialyse
  • Peritonealdialyse
Retrospektive vom Nephrologischen Seminar in Heidelberg, Erfurter Dialysefachtage, Expertenmeeting Dialyse in Erfurt, ERA EDTA in London 2015

ERA-EDTA – News First

ERA-EDTA – News First Guideline on Management of Patients with Diabetes and Chronic Kidney Disease Diabetes mellitus is becoming increasingly prevalent and is considered a rapidly growing concern for healthcare systems. According to the WHO [1] there are currently more than 60 million patients with diabetes in Europe – and patients with diabetes are particularly at risk of developing chronic kidney disease. According to the latest annual report of the ERA-EDTA registry [2], 22.1 % of all new dialysis patients are classified with diabetic nephropathy. Therefore it is to be feared that the global increase of diabetes will result in a higher prevalence of chronic kidney disease, too. Conferences 52 nd ERA-EDTA Congress, London Despite the strong interplay between diabetes and chronic kidney disease (CKD), the management of patients with diabetes and CKD stage 3b or higher (eGFR

ERA-EDTA – News Survival Rate of Dialysis Patients Has Improved At least 70 million Europeans suffer from chronic kidney disease (CKD). However, dialysis patients represent only 1 to 2 % of the CKD population. CKD is clearly a disease that progresses slowly, but steadily – yet even in its early stages, CKD causes a dramatic increase in general and cardiovascular mortality. The sad truth is that many CKD patients die before reaching end-stage renal disease (ESRD), when they are dependent on renal replacement therapy (dialysis, transplantation). Risk calculations indicate that CKD is a negative cardiovascular prognostic factor as such, irrespective of the traditional mortality risks such as cholesterol or blood pressure. Five years ago, a systematic analysis published in the renowned journal ‘The Lancet’ [1] involving more than 1.2 million patients, showed that total as well as cardiovascular mortality can be well estimated using simple kidney function tests. Patients who reach the ESRD stage have a poor outlook and suffer from high cardiovascular morbidity and mortality: Survival chances at the start of dialysis were found to be worse than if colon carcinoma were diagnosed. For years, the efforts of nephrologists have therefore been directed towards improving the high mortality of ESRD patients. New data from the ERA-EDTA Registry now demonstrate that those efforts are paying off: The two-year survival of patients starting renal replacement therapy (RRT) for chronic kidney disease, on dialysis or receiving a living-related kidney transplant increased to 82.2 %, 79.7% and 98.3% in the 2006–2010 cohort (from 80.6 %, 77.5 % and 97.6 % in the 2003-2007 cohort) respectively, while for cadaveric kidney transplantation it has remained stable (96.0–96.1 %). “In other words, the two-year survival of dialysis patients increased by 2 % within three years. That may not be earth-shattering as yet, but it is an encouraging signal. We may be cautiously optimistic of having a positive impact on patient outcomes with good ne phrological care”, comments Prof. Alberto Ortiz, Clinical Kidney Journal‘s editor-in-chief and author of a recently published article [2], in which the 2012 ERA-EDTA Registry Annual Report was analysed and interpreted. “But, of course, there is still lots of room for improvement!” References 1. http://www.thelancet.com/journals/lancet/article/ PIIS0140-6736(10)60674-5/abstract 2. Pippias M, Stel VS, Abad Diez JA et al. Renal replacement therapy in Europe: a summary of the 2012 ERA-EDTA Registry Annual Report. Clin Kidney J 2015; 0: 1–14. Quelle: 52 nd ERA-EDTA Congress, May 28 th –31 st 2015, London Conferences 41

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