Renal Insufficiency Clinical Trial
Official title:
Factors Related to Geographical Variation in the Incidence of End-stage Renal Failure: An Analysis in 5 French Regions
The REIN registry highlights significant disparities in the incidence of end-stage renal
disease (ESRD) between regions, especially in the North East of France. According to the
literature, the incidence of ESRD in an area could be related to contextual factors
influencing the needs for dialysis or transplantation (age structure, prevalence of risk
factors, socioeconomic and morbidity levels), as well as to primary and secondary care
provision (general practitioners and nephrologists) and to practice patterns in nephrology.
The aims of this project are the following:
1. to compare the incidence of renal replacement therapy (dialysis or preemptive
transplantation) for ESRD between the "départements" and the "cantons" belonging to the
5 regions of Eastern France (Alsace, Lorraine, Champagne-Ardenne, Bourgogne and
Franche-Comté), while taking into account differences in population sizes and spatial
patterns of the data,
2. to analyse the relations between incidence disparities and socioeconomic environment,
geographic accessibility to primary and secondary care and medical practice patterns,
after adjusting for morbidity and mortality rates (incidence of diabetes,
cardiovascular mortality).
This project will enable a better understanding of the mechanisms involved in the spatial
variations of ESRD incidence, while disentangling effects related to the need from effects
related to service supply in different socio-economic contexts. It will be possible to
identify a lack of equity in access to renal replacement therapy if, after adjusting for
need indicators, there were variations of incidence of ESRD related to availability of
service or to socioeconomic context. Highlighting such effects would lead to search for
corrective measures in collaboration with the different stakeholders.
n/a
Observational Model: Ecologic or Community, Time Perspective: Retrospective
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