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Abstract: SA-PO313

How Does the United States Compare With Europe in ESRD?

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Cancarevic, Ivan, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Nassar, Mahmoud, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Omran, Ismail, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

End-stage renal disease (ESRD) requiring renal replacement therapy (RRT) due to renal disease or secondary to another disorder, predisposes to numerous complications. In the United States (US), ESRD patients are on Medicare. Europe has public systems. We aimed to find out if either does better at managing ESRD.

Methods

Data for 2015 and 2019 was extracted from the United States Renal Data System (USRDS) and the European Renal Association (ERA) registry. We analyzed ESRD incidence, management and survival.

Results

ESRD incidence in the US rose from 402 to 412, while in Europe from 119 to 132. In Europe, 26-27% of patients are over 75, while in the US >40%. Diabetes was the most common cause in both populations. 75 in a million Americans got transplants, while 35 Europeans did (from 3 in the East to 73 in Spain). The 5-year survival on dialysis was higher in Europe (47% vs 42%). Among 40-50 years olds, Europeans lived 2 years longer on dialysis. Survival after transplant was 24-30 years in the US, 22-27 in Europe.

Conclusion

Older Americans are more likely to be started on dialysis. Survival differences may be explained by better management and adherence among Europeans on dialysis, while the inclusion of developing countries affects survival post-transplant. Analysis of prescribing patterns would be helpful.