Showing papers by "Cécile Couchoud published in 2010"
TL;DR: In this article, mortality hazard ratios associated with modification of Diet in Renal Disease eGFR at dialysis initiation for 11,685 patients from the French REIN Registry, with sequential adjustment for a number of covariates.
137 citations
TL;DR: The impact of increased eGFR at initiation should be taken into account in guidelines recommending earlier dialysis start, as it is shown that geographical variations in renal replacement therapy (RRT) incidence can be explained by varying the timing of dialysis initiation.
Abstract: Background. Variations in the timing of dialysis initiation may explain some geographical variations in renal replacement therapy (RRT) incidence, but this effect has never been quantified. Methods. Using data from the French Renal Epidemiology and Information Network registry, we quantified the association between RRT incidence in 2006–07 and median estimated glomerular filtration rate (eGFR) values before starting dialysis at the administrative district level with geographically appropriate methods. Results. Crude RRT incidence varied from 80.4 to 238.6 pmi between administrative districts, and median eGFR at dialysis initiation from 5.9 to 11.8 ml/min/1.73 m². Age- and sex-adjusted RRT incidence, associated with a 1.2-ml/min/1.73m² increase in median eGFR, rose 8% (4–13%) before and 9% (5–13%) after controlling for the effect of nine potential socioeconomic and medical risk factors. Conclusion. The impact of increased eGFR at initiation should be taken into account in guidelines recommending earlier dialysis start.
30 citations
TL;DR: In this paper, the authors used the U.S. Renal Data System (USRDS) by Burrows et al. to investigate the clinical relevance of this primary renal disease definition when a diabetic population is studied.
Abstract: We read with great interest the report from the U.S. Renal Data System (USRDS) by Burrows et al. (1) that described declining incidence rate of treated end-stage renal disease (ESRD) “related to diabetes” as primary renal disease among estimated U.S. population with diabetes. From 1996 to 2006 the overall incidence rate decreased at an average of 2.9% per year (1).
However, reported results raise the issue of the clinical relevance of this primary renal disease definition when a diabetic population is studied.
In ESRD patients, diabetes might be the cause of chronic kidney disease (diabetic nephropathy) or an associated disease not related to primary renal disease (diabetes as comorbidity). In type 2 diabetic patients …
29 citations