BACKGROUND: Although previous studies suggest similar @entity1 survival for @entity298 ( @entity298 ) and haemodialysis (HD), @entity298 use has decreased worldwide. We aimed to study trends in the choice of first dialysis modality and relate these to variation in @entity1 and technique survival and kidney transplant rates in Europe over the last 20 years. METHODS: We used data from 196 076 @entity1 within the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry who started @entity8 ( @entity8 ) between 1993 and 2012. Trends in the incidence rate and prevalence on Day 91 after commencing @entity8 were quantified with Joinpoint regression. Crude and adjusted hazard ratios (HRs) for 5-year dialysis @entity1 and technique survival were calculated using Cox regression. Analyses were repeated using propensity score matching to control for confounding by indication. RESULTS: @entity298 prevalence dropped since 2007 and HD prevalence stabilized since 2009. Incidence rates of @entity298 and HD decreased from 2000 and 2009, respectively, while the incidence of kidney transplantation increased from 1993 onwards. Similar 5-year @entity1 survival for @entity298 versus HD @entity1 was found in 1993-97 [adjusted HR: 1.02, 95% confidence interval (95% CI): 0.98-1.06], while survival was higher for @entity298 @entity1 in 2003-07 (HR: 0.91, 95% CI: 0.88-0.95). Both @entity298 (HR: 0.95, 95% CI: 0.91-1.00) and HD technique survival (HR: 0.93, 95% CI: 0.87-0.99) improved in 2003-07 compared with 1993-97. CONCLUSIONS: Although initiating @entity8 on @entity298 was associated with favourable @entity1 survival when compared with starting on HD treatment, @entity298 was often not selected as initial dialysis modality. Over time, we observed a significant decline in @entity298 use and a stabilization in HD use. These observations were explained by the lower incidence rate of @entity298 and HD and the increase in pre-emptive transplantation.

Trends in dialysis modality choice and related XXXX survival in the ERA-EDTA Registry over a 20-year period.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity8 :: ('MESH:D007674', 'Disease') :: ['RRT', 'renal replacement therapy'] @entity298 :: ('MESH:D010538', 'Disease') :: ['peritoneal dialysis', 'PD']
@entity1 :: (9606,Species) :: ['patient']
