scholarly journals Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

2021 ◽  
Author(s):  
Marjolein Bonthuis ◽  
Enrico Vidal ◽  
Anna Bjerre ◽  
Özlem Aydoğ ◽  
Sergey Baiko ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Cox Regression ◽  
Patient Survival ◽  
Healthcare Providers ◽  
Resource Planning ◽  
Policy Makers ◽  
Age Related ◽  
Kidney Replacement Therapy ◽  
Over Time ◽  
Related Population

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

scholarly journals MO077TEN YEAR TRENDS IN PAEDIATRIC RENAL REPLACEMENT THERAPY IN EUROPE: DATA FROM THE ESPN/ERA-EDTA REGISTRY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marjolein Bonthuis ◽  
Jerome Harambat ◽  
Enrico Vidal ◽  
Kitty J Jager
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Time Trends ◽  
Cox Regression ◽  
Patient Survival ◽  
Resource Planning ◽  
Treatment Modalities ◽  
Change Over Time ◽  
The Past ◽  
Over Time

Abstract Background and Aims The ESPN/ERA-EDTA Registry includes data on children with end-stage kidney disease receiving renal replacement therapy (RRT) in Europe for 10 consecutive years. We examined time trends in incidence, prevalence and patient survival for paediatric RRT in Europe. Method We included all children aged &lt; 15 years starting RRT in 22 European countries from 2007 to 2016. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age related population (pmarp) and time trends were studied with Joinpoint regression. We analyzed patient survival using Cox regression. Results The incidence of children commencing RRT &lt; 15 years remained stable over the past ten years, varying between 5.5 pmarp to 6.5 pmarp. The incidence by treatment modality did not change over time: 2.0 to 3.0 pmarp for haemodialysis (HD) and peritoneal dialysis (PD) and 1.0 pmarp for transplantation. Overall prevalence rose by 2% annually (95% CI: 1.5-2.3%) from 29.5 pmarp in 2007 to 35.6 pmarp in 2016. The increase in prevalence was observed in all age categories, but was strongest among children older than 5 years at RRT initiation. The prevalence of patients on all treatment modalities increased during the study period: from 4.5 to 5.4 pmarp for HD, from 4.9 pmarp to 6.0 pmarp for PD and from 19.6 to 23.9 pmarp for transplantation (Figure). Four-year adjusted patient survival on RRT was around 96% and similar for those initiating from 2007-2009 and from 2010-2012 (adjusted HR: 0.97, 95% CI: 0.69-1.36). Conclusion Over the past decade we found a stable incidence and an increasing prevalence of European children on RRT. Four-year patient survival was good, and did not change over time. These data are important to inform patients and healthcare providers and to aid health policy makers on future resource planning of pediatric RRT in Europe.

Patients’ experiences of transitioning between different renal replacement therapy modalities: A qualitative study

2020 ◽  
Vol 40 (6) ◽  
pp. 548-555 ◽  
Author(s):  
Els Holvoet ◽  
Sofie Verhaeghe ◽  
Simon Davies ◽  
Gill Combes ◽  
Karlien François ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Sense Of Self ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Dialysis Unit ◽  
Home Based ◽  
Kidney Replacement Therapy ◽  
End Stage ◽  
Patients Experience ◽  
Care Requirements

Background: Different kidney replacement therapy modalities are available to manage end-stage kidney disease, such as home-based dialysis, in-center hemodialysis, and kidney transplantation. Although transitioning between modalities is common, data on how patients experience these transitions are scarce. This study explores patients’ perspectives of transitioning from a home-based to an in-center modality. Methods: Patients transitioning from peritoneal dialysis to in-center hemodialysis were purposively selected. Semi-structured interviews were performed, digitally recorded, and transcribed verbatim. Data analysis, consistent with Charmaz’ constructivist approach of grounded theory was performed. Results: Fifteen patients (10 males; mean age 62 years) participated. The conditions of the transitioning process impacted the participants’ experiences, resulting in divergent experiences and associated emotions. Some participants experienced a loss of control due to the therapy-related changes. Some felt tied down and having lost independence, whereas others stated they regained control as they felt relieved from responsibility. This paradox of control was related to the patient having or not having (1) experienced a fit of hemodialysis with their personal lifestyle, (2) a frame of reference, (3) higher care requirements, (4) insight into the underlying reasons for transitioning, and (5) trust in the healthcare providers. Conclusions: Care teams need to offer opportunities to elicit patients’ knowledge and fears, dispel myths, forge connections with other patients, and visit the dialysis unit before transition to alleviate anxiety. Interventions that facilitate a sense of control should be grounded in the meaning that the disorder has for the person and how it impacts their sense of self.

scholarly journals Growth in children on kidney replacement therapy: a review of data from patient registries

2021 ◽  
Author(s):  
Marjolein Bonthuis ◽  
Jérôme Harambat ◽  
Kitty J. Jager ◽  
Enrico Vidal
Keyword(s):  
Replacement Therapy ◽  
Critical Period ◽  
Linear Growth ◽  
Final Height ◽  
Major Complication ◽  
Original Data ◽  
Paediatric Nephrology ◽  
Patient Registries ◽  
Kidney Replacement Therapy ◽  
Over Time

AbstractGrowth retardation is a major complication in children with chronic kidney disease (CKD) and on kidney replacement therapy (KRT). Conversely, better growth in childhood CKD is associated with an improvement in several hard morbidity–mortality endpoints. Data from pediatric international registries has demonstrated that improvements in the overall conservative management of CKD, the search for optimal dialysis, and advances in immunosuppression and kidney transplant techniques have led to a significant improvement of final height over time. Infancy still remains a critical period for adequate linear growth, and the loss of stature during the first years of life influences final height. Preliminary new original data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) Registry confirm an association between the final height and the height attained at 2 years in children on KRT.

Fatherhood and Kidney Replacement Therapy: Analysis of the Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry

2020 ◽  
Vol 76 (3) ◽  
pp. 444-446
Author(s):  
Shilpanjali Jesudason ◽  
Alyssa Fitzpatrick ◽  
Aarti Gulyani ◽  
Christopher E. Davies ◽  
Erandi Hewawasam ◽  
...  
Keyword(s):  
New Zealand ◽  
Replacement Therapy ◽  
Kidney Replacement Therapy ◽  
Anzdata Registry

Information Practices of Baby Boomers as Caregivers

2013 ◽  
Author(s):  
Khuan Seow ◽  
Nadia Caidi
Keyword(s):  
Social Policy ◽  
Baby Boomers ◽  
Information Needs ◽  
Family Members ◽  
Age Groups ◽  
Maladie D’Alzheimer ◽  
Policy Makers ◽  
Age Related ◽  
The Family ◽  
Growing Age

Canada has an aging population with the fastest growing age groups (80 and 45-64 years old) vulnerable to age-related diseases such as Alzheimer’s disease. Caregiving responsibilities often fall to the family members of the afflicted without much attention and consideration being placed on the information needs of these caregivers. We call for a better understanding of these caregivers' information needs and uses by social policy makers as well as information providers.La population du Canada a tendance à vieillir considérablement, avec la hausse la plus rapide dans les groupes d’âge (80 et 45 à 64 ans). Les personnes âges sont très vulnérables à toute sorte de maladies, telles que la maladie d’Alzheimer. La responsabilité revient souvent aux membres de la famille qui doivent prendre soin des personnes atteintes de cette maladie. Or, nous ne connaissons que peu de chose sur les besoins en information des personnes qui prennent soin de ces malades de l’Alzheimer : qui sont-ils ? Quelles sont leurs sources... 

Intra-sectoral and Intersectoral Parity Issues in Pricing of Agricultural Crops: A Preliminary Analysis

1987 ◽  
Vol 26 (4) ◽  
pp. 401-417
Author(s):  
Sarfraz K. Qureshi
Keyword(s):  
Preliminary Analysis ◽  
Agricultural Sector ◽  
Terms Of Trade ◽  
Agricultural Crops ◽  
Allocation Of Resources ◽  
Price Determination ◽  
Policy Makers ◽  
The Government ◽  
Distribution Of Income ◽  
Over Time

Intersectoral terms of trade play a cruc1al role in determining the sectoral distribution of income and resource allocation in the developing countries. The significance of intra-sectoral terms of trade for the allocation of resources within the agricultural sector is also widely accepted by research scholars and policy-makers. In the context of planned development, the government specifies production targets for the agricultural sector and for different crops. The intervention of government in the field of price determination has important implications for the achievement of planned targets. In Pakistan, there is a feeling among many groups including farmers and politicians with a rural background that prices of agricultural crops have not kept their parities intact over time and that prices generally do not cover the costs of production. The feeling that production incentives for agriculture have been eroded is especially strong for the period since the early 1970s. It is argued that strong inflationary pressures supported by a policy of withdrawal of government subsidies on agricultural inputs have resulted in rapid increases in the prices paid by agriculturists and that increases in the prices received by farmers were not enough to compensate them for the rising prices of agricultural inputs and consumption goods.

The Role of Vascular Aging in Atherosclerotic Plaque Development and Vulnerability

2019 ◽  
Vol 25 (29) ◽  
pp. 3098-3111 ◽  
Author(s):  
Luca Liberale ◽  
Giovanni G. Camici
Keyword(s):  
Atherosclerotic Plaque ◽  
Molecular Mechanisms ◽  
Driving Forces ◽  
Plaque Burden ◽  
Vascular Aging ◽  
Age Related ◽  
Plaque Development ◽  
Increased Risk ◽  
The Impact ◽  
Over Time

Background: The ongoing demographical shift is leading to an unprecedented aging of the population. As a consequence, the prevalence of age-related diseases, such as atherosclerosis and its thrombotic complications is set to increase in the near future. Endothelial dysfunction and vascular stiffening characterize arterial aging and set the stage for the development of cardiovascular diseases. Atherosclerotic plaques evolve over time, the extent to which these changes might affect their stability and predispose to sudden complications remains to be determined. Recent advances in imaging technology will allow for longitudinal prospective studies following the progression of plaque burden aimed at better characterizing changes over time associated with plaque stability or rupture. Oxidative stress and inflammation, firmly established driving forces of age-related CV dysfunction, also play an important role in atherosclerotic plaque destabilization and rupture. Several genes involved in lifespan determination are known regulator of redox cellular balance and pre-clinical evidence underlines their pathophysiological roles in age-related cardiovascular dysfunction and atherosclerosis. Objective: The aim of this narrative review is to examine the impact of aging on arterial function and atherosclerotic plaque development. Furthermore, we report how molecular mechanisms of vascular aging might regulate age-related plaque modifications and how this may help to identify novel therapeutic targets to attenuate the increased risk of CV disease in elderly people.

Anti-corruption in History

2017 ◽  
Keyword(s):  
Financial Institutions ◽  
Global Media ◽  
Policy Makers ◽  
The Past ◽  
Human Wellbeing ◽  
Modern Period ◽  
Legitimate Power ◽  
Wide Range ◽  
Scant Attention ◽  
Over Time

Anticorruption in History is the first major collection of case studies on how past societies and polities, in and beyond Europe, defined legitimate power in terms of fighting corruption and designed specific mechanisms to pursue that agenda. It is a timely book: corruption is widely seen today as a major problem, undermining trust in government, financial institutions, economic efficiency, the principle of equality before the law and human wellbeing in general. Corruption, in short, is a major hurdle on the “path to Denmark”—a feted blueprint for stable and successful statebuilding. The resonance of this view explains why efforts to promote anticorruption policies have proliferated in recent years. But while the subjects of corruption and anticorruption have captured the attention of politicians, scholars, NGOs and the global media, scant attention has been paid to the link between corruption and the change of anticorruption policies over time and place. Such a historical approach could help explain major moments of change in the past as well as reasons for the success and failure of specific anticorruption policies and their relation to a country’s image (of itself or as construed from outside) as being more or less corrupt. It is precisely this scholarly lacuna that the present volume intends to begin to fill. A wide range of historical contexts are addressed, ranging from the ancient to the modern period, with specific insights for policy makers offered throughout.

scholarly journals The prevalence of underweight in 9–10-year-old schoolchildren in Liverpool: 1998–2006

2009 ◽  
Vol 12 (7) ◽  
pp. 953-956 ◽  
Author(s):  
Lynne M Boddy ◽  
Allan F Hackett ◽  
Gareth Stratton
Keyword(s):  
Mass Spectrum ◽  
Body Mass ◽  
The Body ◽  
Fitness Testing ◽  
Policy Makers ◽  
Substantial Problem ◽  
Prevalence Of Obesity ◽  
Grade 3 ◽  
The City ◽  
Over Time

AbstractObjectiveTo estimate the prevalence of underweight between 1998 and 2006 in Liverpool schoolchildren aged 9–10 years using recently published underweight cut-off points.Design and settingStature and body mass data collected at the LiverpoolSportsLinx project’s fitness testing sessions were used to calculate BMI.SubjectsData were available on 26 782 (n13 637 boys, 13 145 girls) participants.ResultsOverall underweight declined in boys from 10·3 % in 1998–1999 to 6·9 % in 2005–2006, and all sub-classifications of underweight declined, in particular grade 3 underweight, with the most recent prevalence being 0·1 %. In girls, the prevalence of underweight declined from 10·8 % in 1998–1999 to 7·5 % in 2005–2006. The prevalence of all grades of underweight was higher in girls than in boys. Underweight showed a fluctuating pattern across all grades over time for boys and girls, and overall prevalence in 2005–2006 represents over 200 children across the city.ConclusionsUnderweight may have reduced slightly from baseline, but remains a substantial problem in Liverpool, with the prevalence of overall underweight being relatively similar to the prevalence of obesity. The present study highlights the requirement for policy makers and funders to consider both ends of the body mass spectrum when fixing priorities in child health.

scholarly journals Introduction to the special issue: multiple jobholding in Europe

2021 ◽  
Vol 27 (2) ◽  
pp. 141-147
Author(s):  
Wieteke Conen ◽  
Karin Schulze Buschoff
Keyword(s):  
Labour Market ◽  
Social Protection ◽  
Special Issue ◽  
Clear Trend ◽  
Policy Makers ◽  
Quality Of Work ◽  
Labour Market Flexibility ◽  
Employment Situation ◽  
Over Time

In a number of European countries there is a clear trend towards increased multiple jobholding. As things stand, however, little is known about the structure and the potential consequences of this increase, notably in terms of quality of work and social protection. This special issue focuses on contemporary forms of multiple jobholding in Europe. Have the structure, nature and dynamics of multiple jobholding changed over time? What are the roles of labour market flexibility, technological change and work fragmentation in the development of multiple jobholding? And do multiple jobholders benefit from similar and adequate employment terms, conditions and protections compared with single jobholders, or are they worse off as a consequence of their (fragmented) employment situation? What implications do these findings have for unions, policy-makers and the regulation of work? The collection of articles in this special issue adds to the literature on emerging forms of employment in the digital age and challenges for social protection, also in light of the COVID-19 pandemic. This introduction initiates a discussion of central debates on multiple jobholding and presents a synopsis of the articles in this issue.

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