LAUSR

Whereas the progressive increase in the incidence of advanced age patients on chronic dialysis is widely described, the incidence trend concerning younger age patients, a potentially useful datum for the health services programming, has been little investigated. The Regional Dialysis Registry of Emilia-Romagna (a region in the north of Italy, near 4,460,000 inhabitants) has been active for 24 years. We analysed the changing incidence in dialysis over time, as a function of 6 different age brackets (excluding the extreme ages, <20 and >90, due to the small numbers involved). The study considered only hemodialysis patients, not peritoneal dialysis, due to small numbers, and in order to collect data from a more homogeneous population. For each year from 1994 to 2017, we extracted the percentage incidence on dialysis of each age bracket [(number of cases per bracket/overall number of incident patients)%]. We then carried out a correlation analysis as a function of time. The incidence on dialysis turned out to change over time with statistical significance in each one of the age brackets except 70-80. The incidence-time association was positive for the brackets 70-80 and 80-90, and negative for the remaining age brackets (Table 1). A scissor-like trend appeared evident when comparing the most advanced ages with the youngest ones (Figure 1). Besides the well-known increase in old patients on chronic dialysis, it should be noted that, on the contrary, younger patients have tended to decrease significantly, at least in our Region. Even bearing in mind the limits of a Registry study, these data may support the value of health programs for the early diagnosis of nephropathy, because prompt pharmacological treatment (at least for glomerular or post-infective, or congenital/hereditary diseases) could reduce the attainment of ESRD and account for the results observed in the lower age-brackets.