NDT Plus Advance Access published online on October 19, 2009
NDT Plus, doi:10.1093/ndtplus/sfp146
The EVEREST study: an international collaboration*
1 Richard Bright Renal Unit, Bristol, UK
2 Clinical Sciences North Bristol, University of Bristol, Bristol, UK
3 ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
4 HERU, University of Aberdeen, Aberdeen, UK
5 Societatea Romana de Nefrologie and University of Medicine, "Gr T Popa", Iasi, Romania
6 Sociedad Latinoamericana de Nefrologia e Hipertensión, Latin America
7 CEMIC University Institute, Buenos Aires, Argentina
8 Inserm U780, Villejuif, France
9 Univ Paris-Sud, Villejuif, France
10 School of Medicine and Dentistry, Division of Applied Sciences, University of Aberdeen, Aberdeen, UK
Correspondence: Fergus J. Caskey; E-mail: fergus.caskey{at}nbt.nhs.uk or fjcaskey{at}doctors.org.uk
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Abstract |
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Rates of initiation of renal replacement therapy (RRT), use of home modalities of treatment and patient outcomes vary considerably between countries. This paper reports the methods and baseline characteristics of countries participating in the EVEREST study (n = 46), a global collaboration examining the association between medical and non-medical factors and RRT incidence, modality mix and survival. Numbers of incident and prevalent patients were collected for current (2003–05) and historic (1983–85, 1988–90, 1993–95 and 1998–2000) periods stratified, where available, by age, gender, treatment modality and cause of end stage renal disease (diabetic versus non-diabetic). General population age and health indicators and national-level macroeconomic data were collected from secondary data sources. National experts provided primary data on renal service funding, resources and organization. The median (inter quartile range) RRT incidence per million of the population (pmp) was 130 pmp (102–167 pmp). The general population life expectancy at 60 was 22.1 years (19.7–23.1 years) and 6.9% had diabetes mellitus (5.4–9.0%). Healthcare spending as a percentage of gross domestic product was 8.1% (5.6–9.3%). Countries averaged nine dialysis facilities pmp (4–12 pmp), with 69.0% (43.9–99.0%) owned by the public or private not-for-profit sector. The number of nephrologists ranged from 0.5 to 48 pmp (median 12 pmp). The heterogeneity of EVEREST countries will enable modelling to examine the independent association between medical and non-medical factors on RRT epidemiology.
Key Words: dialysis • epidemiology and outcomes • risk factors
Received for publication September 16, 2009. Accepted for publication September 20, 2009.
* The EVEREST study is supported by the ERA-EDTA Quality European Studies (QUEST) Initiative.