Épidémiologie des maladies rénales chroniques

Abstract

In France, chronic kidney insufficiency is a frequent pathology (3300 cases per million persons, [pmp]). At discovery, a diagnostic procedure is required. The frequency of chronic glomerulonephritis, uropathies, type 1 diabetes is still decreasing. Today, the leading causes are type 2 diabetes and age-related vascular nephropathies. The progression of chronic kidney insufficiency to end-stage renal disease is not inevitable. Treatment to slower progression and preventive attitudes against toxic interventions and cardiovascular risk factors are possible. Moreover, early nephrology referral is associated with better outcomes after initiation of renal replacement therapy, i.e. dialysis or transplantation. In 2003, 7 regions participate to the French registry of end-stage renal diseases. The annual incidence rate was de 122 pmp. Almost 7000 patients per year start dialysis. Before the age of 65, the incidence is constant. Since 1998 in Lorraine, it increases by 3% per year between 65/74 years of age, by 13% per year between 75/84 years of age, by 40% per year between above 85 years. In June 2003, the prevalence of dialysis was 513 pmp. Variations between administrative regions are remarkable. After adjustment, the Nord-Pas-de-Calais region has the highest prevalence. In Martinique and Guadeloupe, the prevalence is higher than in French metropolis. In the Réunion island, the burden of dialysis is as important as in the United-States. From 1992 to 2002, the total prevalence, i.e. dialysis and kidney transplantation, increased by 7.4% per year in Limousin, by 8.8% in Lorraine. The prevalence of patients with a kidney graft doubled in both regions. Almost 45000 French people benefited from dialysis or transplantation. The frequency of type 2 diabetes and cardiovascular diseases in the population seems to be the first factor that impacts the need for kidney replacement therapy. The French registry brings epidemiological data that allowed adapting supply of care to demands.