A comparison of the epidemiology of kidney replacement therapy between Europe and the United States: 2021 data of the ERA Registry and the USRDS.

BACKGROUND AND HYPOTHESIS: This paper compares the most recent data on the incidence and prevalence of kidney replacement therapy (KRT), kidney transplantation rates, and mortality on KRT from Europe to those from the United States (US), including comparisons of treatment modalities (haemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx)). METHODS: Data were derived from the annual reports of the European Renal Association (ERA) Registry and the United States Renal Data System (USRDS). The European data include information from national and regional renal registries providing the ERA Registry with individual patient data. Additional analyses were performed to present results for all participating European countries together. RESULTS: In 2021, the KRT incidence in the US (409.7 per million population (pmp)) was almost 3-fold higher than in Europe (144.4 pmp). Despite the substantial difference in KRT incidence, approximately the same proportion of patients initiated HD (Europe: 82%, US: 84%), PD (14%; 13% respectively), or underwent pre-emptive KTx (4%; 3% respectively). The KRT prevalence in the US (2436.1 pmp) was 2-fold higher than in Europe (1187.8 pmp). Within Europe, approximately half of all prevalent patients were living with a functioning graft (47%), while in the US, this was one third (32%). The number of kidney transplantations performed was almost twice as high in the US (77.0 pmp) compared to Europe (41.6 pmp). The mortality of patients receiving KRT was 1.6-fold higher in the US (157.3 per 1000 patient years) compared to Europe (98.7 per 1000 patient years). CONCLUSIONS: The US had a much higher KRT incidence, prevalence, and mortality compared to Europe, and despite a higher kidney transplantation rate, a lower proportion of prevalent patients with a functioning graft

Ocean Applications

In this chapter, the most promising techniques to observe oil slicks and to detect metallic targets at sea using polarimetric synthetic aperture radar (SAR) data are reviewed and critically analysed. The detection of oil slicks in SAR data is made difficult not only by the presence of speckle but also by the presence of, e.g. biogenic films, low-wind areas, rain cells, currents, etc., which increase the false alarm probability. The use of polarimetric features has been shown to both observe oil slicks and distinguish them from weak-damping look-alikes but also to extract some of their properties. Similarly to oil slicks, the same factors can hamper the detection of metallic targets at sea. The radiometric information provided by traditional single-channel SAR is not generally sufficient to unambiguously detect man-made metallic targets over the sea surface. This shortcoming is overcome by employing polarimetry, which allows to fully characterize the scattering mechanism of such targets

Interpreting sea surface slicks on the basis of the normalized radar cross-section model using RADARSAT-2 copolarization dual-channel SAR images

A simple automatic multipolarization technique for discrimination of main types of thin oil films (of thickness less than the radio wave skin depth) from natural ones is proposed. It is based on a new multipolarization parameter related to the ratio between the damping in the slick of specially normalized resonant and nonresonant signals calculated using the normalized radar cross-section model proposed by Kudryavtsev et al. (2003a). The technique is tested on RADARSAT-2 copolarization (VV/HH) synthetic aperture radar images of slicks of a priori known provenance (mineral oils, e.g., emulsion and crude oil, and plant oil served to model a natural slick) released during annual oil-on-water exercises in the North Sea in 2011 and 2012. It has been shown that the suggested multipolarization parameter gives new capabilities in interpreting slicks visible on synthetic aperture radar images while allowing discrimination between mineral oil and plant oil slicks

Incidence of Kidney Replacement Therapy and Subsequent Outcomes Among Patients With Systemic Lupus Erythematosus: Findings From the ERA Registry

Rationale & Objective There is a dearth of data characterizing patients receiving kidney replacement therapy (KRT) for kidney failure due to systemic lupus erythematosus (SLE) and their clinical outcomes. The aim of this study was to describe trends in incidence and prevalence of KRT among these patients as well as to compare their outcomes versus those of patients treated with KRT for diseases other than SLE. Study Design Retrospective cohort study based on kidney registry data. Setting & Participants Patients recorded in 14 registries of patients receiving KRT that provided data to the European Renal Association Registry between 1992 and 2016. Predictor SLE as cause of kidney failure. Outcomes Incidence and prevalence of KRT, patient survival while receiving KRT, patient and graft survival after kidney transplant, and specific causes of death. Analytical Approach Kaplan-Meier methods and Cox regression models were fit to compare patient survival between the SLE and non-SLE groups, overall KRT, dialysis, and patient and graft survival after kidney transplant. Results In total, 1,826 patients commenced KRT for kidney failure due to SLE, representing an incidence of 0.80 per million population (pmp) per year. The incidence remained stable during the study period (annual percent change, 0.1% [95% CI, −0.6% to 0.8%]). Patient survival among patients with SLE receiving KRT was similar to survival in the comparator group (hazard ratio [HR], 1.11 [95% CI, 0.99-1.23]). After kidney transplant, the risk of death was greater among patients with SLE than among patients in the comparator group (HR, 1.25 [95% CI, 1.02-1.53]), whereas the risk of all-cause graft failure was similar (HR, 1.09 [95% CI, 0.95-1.27]). Ten-year patient overall survival during KRT and patient and graft survival after kidney transplant improved over the study period (HRs of 0.71 [95% CI, 0.56-0.91], 0.43 [95% CI, 0.27-0.69], and 0.60 [95% CI, 0.43-0.84], respectively). Patients with SLE receiving KRT were significantly more likely to die of infections (24.8%) than patients in the comparator group (16.9%; P < 0.001). Limitations No data were available on extrarenal manifestations of SLE, drug treatments, comorbidities, kidney transplant characteristics, or relapses of SLE. Conclusions The prognosis of patients with SLE receiving KRT has improved over time. Survival of patients with SLE who required KRT was similar compared with patients who required KRT for other causes of kidney failure. Survival following kidney transplants was worse among patients with SLE

Incidence of Kidney Replacement Therapy and Subsequent Outcomes Among Patients With Systemic Lupus Erythematosus: Findings From the ERA Registry

International audienceRATIONALE AND OBJECTIVE: There is a dearth of data characterizing patients requiring kidney replacement therapy (KRT) for kidney failure due to systemic lupus erythematosus (SLE) and their clinical outcomes. The aim of this study was to describe trends in incidence and prevalence of KRT among these patients as well as to compare their outcomes to patients treated with KRT for diseases other than SLE. STUDY DESIGN: Retrospective cohort study based on kidney registry data. SETTING & PARTICIPANTS: Patients recorded in 14 registries of patients receiving kidney replacement therapy that provided data to the European Renal Association (ERA) Registry between 1992 and 2016. PREDICTOR: SLE as cause of kidney failure. OUTCOMES: Incidence and prevalence of KRT, patient survival while receiving KRT, patient and graft survival after kidney transplantation, and specific causes of death. ANALYTICAL APPROACH: Kaplan-Meier methods and Cox regression models were fit to compare patient survival between the SLE and non-SLE groups, overall KRT, dialysis and patient and graft survival after kidney transplantation. RESULTS: In total, 1826 patients commenced KRT for kidney failure due to SLE, representing an incidence of 0.80 per million population (pmp) per year. The incidence remained stable during the study period (annual percent change=0.1 [95%CI: -0.6 ; 0.8]). Patient survival among patients with SLE receiving KRT was similar to survival within the comparator group (HR=1.11 [95%CI: 0.99-1.23]). After kidney transplantation, the risk of death was greater among patients with SLE than among patients within the comparator group (HR=1.25 [95%CI: 1.02-1.53]), while the risk of all-cause graft failure was similar (HR=1.09 [95%CI: 0.95-1.27]). Ten-year patient overall survival on KRT, and patient and graft survival after kidney transplantation improved over the study period (HR=0.71 [95%CI: 0.56-0.91], 0.43 [0.27-0.69] and 0.60 [0.43-0.84], respectively). Patients with SLE receiving KRT were significantly more likely to die from infections (24.8%) than patients in the comparator group (16.9%, p<0.001). LIMITATIONS: No data were available on extrarenal manifestations of SLE, drug treatments, comorbidities, kidney transplant characteristics, or relapses of SLE. CONCLUSION: The prognosis of patients with SLE receiving KRT has improved over time. Survival of patients with SLE requiring KRT was similar when compared to patients requiring KRT due to other causes of kidney failure. Survival following kidney transplantation was worse among patients with SLE