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Table 3 Access to kidney replacement therapy

From: End-stage kidney disease and rationing of kidney replacement therapy in the free state province, South Africa: a retrospective study

 

2016 (n = 63)

2017 (n = 101)

2018 (n = 103)

p-value

Total (%, 95 % CI) (n = 267)

p-value

ESKD incidence rate, pmp (95 % CI)

26.7 (20.0–33.4)

41.4 (33.2–49.6)

41.6 (33.4–49.8)

0.006a

0.005b

110.1 (96.6–123.6)

 

Accepted for dialysis, n (%)

19/63 (30.2 %; 20.0–42.8 %)

28/101 (27.7 %; 19.8–37.3 %))

35/103 (34.0 %; 25.4–43.7 %))

0.622

82/267 (30.7 %; 25.4–36.5 %))

 

KRT incidence, pmp (95 % CI)

8.05 (4.98–11.1)

11.5 (7.83–15.1)

14.1 (10.3–18.0)

0.230a

0.045b

33.8 (27.7–39.9)

 

Age (years), median (IQR)

36 (32–48)

43 (35–50)

40 (31–48)

0.131

40 (33–49)

 

Hypertension, n (%)

27/63 (42.8)

50/101 (49.5)

36/103 (35.0)

0.109

113/267 (42.3, 36.5–48.4)

 

Diabetes, n (%)

13/63 (20.6)

21/101 (20.8)

17/103 (16.5)

0.693

51/267 (19.1, 14.8–24.3)

 

HIV, n (%)

13/63 (20.6)

30/101 (29.7)

33/103 (32.0)

0.270

76/267 (28.5, 23.4–34.2)

 

Serum creatinine (µmol/L), median (IQR)

807 (529–1050)

995.5 (708–1050)

883 (650–1184)

0.033

890 (670–1210)

 

Reason for exclusion from KRT programme

  Concomitant organ dysfunction, n (%)

25/44 (56.8)

45/73 (61.6)

39/68 (57.4)

0.830

109/185 (58.9; 51.6–65.8)

Reference

     Cardiac disease, n (%)

9/44 (20.4)

16/73 (21.9)

22/68 (32.4)

0.250

47/185 (25.4;19.6–32.2)

Reference

     Vascular disease, n (%)

7/44 (20.4)

8/73 (23.3)

12/68 (16.2)

0.511

27/185 (14.6; 10.2–20.5)

0.009

     Pulmonary hypertension, n (%)

9/44 (20.4)

17/73 (23.3)

11/68 (16.2)

0.571

37/185 (20.0; 14.8–26.4)

0.215

     Lung disease, n (%)

1/44 (2.3)

5/73 (6.8)

2/68 (2.9)

0.467

8/185 (4.3; 2.2–8.4)

< 0.001

  Noncompliance, n (%)

4/44 (9.1)

2/73 (2.7)

4/68 (5.9)

0.286

10/185 (5.4; 2.9–9.8)

< 0.001

  Psychosocial, n (%)

2/44 (4.6)

2/73 (2.7)

4/68 (5.9)

0.660

8/185 (4.3; 2.2–8.4)

< 0.001

  Substance abuse, n (%)

2/44 (4.6)

4/73 (5.5)

1/68 (1.5)

0.483

7/185 (3.8; 1.8–7.8)

< 0.001

  Diabetes and age ≥ 50 years, n (%)

3/44 (6.8)

9/73 (12.3)

2/68 (2.9)

0.124

14/185 (7.6; 4.5–12.4)

< 0.001

  Uncontrolled HIVc, n (%)

3/44 (6.8)

9/73 (12.3)

9/68 (13.2)

0.610

21/185 (11.4; 7.5–16.8)

< 0.001

  Age ≥ 60 years, n (%)

4/44 (9.1)

7/73 (9.6)

6/68 (8.8)

1.000

17/185 (9.2; 5.8–14.3)

< 0.001

  BMI ≥ 35 kg/m2, n (%)

3/44 (6.8)

3/73 (4.1)

7/68 (10.3)

0.357

13/185 (7.0; 4.1–11.8)

< 0.001

  Other, n (%)

2/44 (4.6)

3/73 (4.1)

4/68 (5.9)

0.910

9/185 (4.9; 2.5–9.1)

< 0.001

  1. BMI body mass index; CI confidence interval; ESKD end-stage kidney disease; HIV human immunodeficiency virus; IQR interquartile range; pmp per-million-population; KRT kidney replacement therapy
  2. aComparison of 2016 and 2017 incidence rates
  3. bComparison of 2016 and 2018 incidence rates
  4. cUncontrolled HIV refers to unsuppressed viral load