[Changes in the uremic population overtime: data from the Italian Registry of Dialysis and Transplantation (RIDT)]

Over the last years in the industrialized countries there have been many changes in the number and characteristics of patients starting renal replacement therapy. This review reports the changes that took place in Italy, analyzing the data from the Italian Registry of Dialysis and Transplantation (RIDT), which collects information from all Italian regions according to common inclusion and coding parameters. The years between 1999 and 2009 were analyzed for the calculation of the average and median age of incident patients, the percent distribution of the different diseases necessitating dialysis, and the mortality after one year. Patients who underwent a kidney transplant as the first event were not included in the analysis. The incidence of uremia in Italy showed a constant increase from 1999 (131 pmp) to 2009 (160 pmp), mainly due to an increase in patients aged over 70 years. In fact, in recent years about 50% of the patients who started renal replacement therapy were aged over 72, 25% were older than 78 years, and only 25% were younger than 60 years. According to the Italian epidemiological data, the percentage of patients with diabetic nephropathy or diabetes as comorbidity has risen steadily (from 19% in 1999 to 27% in 2009). However, in spite of the progressive increase in the two main risk factors for survival (older age and diabetes), the mortality after one year of renal replacement therapy did not show a significant rise from 1999 to 2009.