20 years of French Renal Registry (REIN) – with comparisons to UK
A recent study by Kazes, 2024, reported the latest data from the French Renal Epidemiology and Information Network (REIN), which is now 20 years old. It also looked at trends comparing 2012 to 2021. There is an older UK equivalent called the UK Renal Registry, with similar objectives. We compare some of the French data to the UKs.
Why is this important?
REIN is not just a national data registry, but rather an epidemiological and informational network serving patients with chronic kidney disease, nephrology teams and health services.
What did the study show?
In France, the incidence (number of new patients) of patients with treated end-stage renal failure (ESRF) was 169 per million population (pmp) in 2021. It was stable despite an increase in the incidence of diabetes.
This is quite ‘high’ by European standards. At a similar time, the incidence in England was 108 pmp (Astley, 2023)
The authors found a decreasing trend in the proportion of patients starting dialysis in an emergency but an increase in those starting haemodialysis (HD) with a temporary catheter.
Peritoneal dialysis decreased by 1.7% each year, whereas home HD, although involving only 1% of dialysis patients, increased by 10% each year. Similar changes are happening in the UK.
For patients not treated at home, the median time to drive from the patient’s home to the dialysis unit was 17 min. CKDEx thinks this is ‘good’ by UK standards. We think UK patients will take alot longer to get to their dialysis unit.
The proportion of patients on the transplantation waitlist at the start of dialysis increased from 7% to 12%. Among the 111,263 new ESRF patients from 2012 to 2021, 8% received a first transplant at 1 year and 20% at 5 years.
Amongst kidney transplant recipients, the mean time on the waitlist increased from 13.8 to 22.6 months (it is 16.3 months (497 days) in the UK).
Living donor transplants increased in frequency, representing 15% of kidney transplants. In 2022/23, 28% of kidney transplants were from living donors in the UK.
How does this affect you?
If you are French, or reading this from France, it might. The higher rate of new patients with ESRF is hard to interpret. There are various possible explanations:
- It is a ‘good thing’ – as France has better dialysis facilities than the UK, so can offer dialysis to more CKD5 patients
- It is a ‘bad thing’ – as French doctors (especially GPs) are not preventing dialysis in sufficient numbers of people
- The likelihood of ESRF is higher in France is higher for some other reason (e.g. higher rate of diabetes)
- Differences in data collection
- A combination of some/all of the above.
Like REIN, it the UK Renal Registry produces a yearly report (latest one here). It is a great source of Information for patients with CKD/ESRF and their doctors and other renal health professionals.
Other resource
NHS Blood and Transplant also produces a yearly report. This is the latest one: 2022/23. This is also worth a read, especially as it shows the (quite different) performances from the 23 UK kidney transplant units. Have a look for yours.
For example, the average waiting time for an adult deceased donor transplant in 2017 -20 was 497 days. This ranged from 235 days at Oxford to 707 days at The Royal Free.
Also the West London transplant unit had the highest number of adult deceased donor kidney transplants per million population (79) per year, and Edinburgh had the least (22).
Last Reviewed on 26 June 2024
