The aims of this study are (1) to compare the prevalence of co-morbidity in patients starting renal replacement therapy in different parts of Europe; (2) to describe how co-morbidity affects ESRD patient’s health outcomes, such as survival and access to renal transplantation; (3) to determine to what extent the differences in co-morbidity explain the differences in outcome; and (4) to examine the added value of co-morbidity data in the international comparison of patient survival, compared to the use of the current ERA-EDTA Registry ‘core’ data set including demographics and underlying renal disease.
We therefore started a study together with five of the national and regional renal registries in Europe that already collect co-morbidity data at the start of RRT, including Austria, Italy (Lombardy), Norway, Spain (Catalonia) and the United Kingdom (England and Wales). In addition, the data of the NECOSAD study, a large Dutch cohort study among dialysis patients, are used to determine whether a more extensive co-morbidity data collection is ‘better’ than a relatively limited one. The results will be used to advise the registries collaborating with the ERA-EDTA Registry on co-morbidity data collection.
Preliminary results show that the prevalence of diabetes mellitus, ischaemic heart disease and peripheral vascular disease was highest in Austria and, secondly, that after adjustment for age, gender and renal disease, the international difference in co-morbidity explained less of the international difference in patient survival than expected.