Kidney replacement therapy for men and women according to the ERA Registry and the USRDS.
BACKGROUND This paper compares the incidence and prevalence of kidney replacement therapy (KRT), kidney transplantation rates, and mortality on KRT between Europe and the United States (US), including sex comparisons. METHODS Data were derived for 2022 from the population-based European Renal Association (ERA) Registry and the United States Renal Data System (USRDS). RESULTS In 2022, the KRT incidence in the US (388.7 per million population (pmp)) was 2.7-fold higher than in Europe (146.2 pmp), with a greater difference for women (3.2-fold) than for men (2.4-fold). The proportion of women initiating KRT was lower in Europe (35%) than in the US (41%). Between 2013 and 2022, the KRT incidence in Europe was stable in women (+0.1% annually), but increased in men (+1.1%). In the US, the KRT incidence increased similarly in women (+0.2%) and men (+0.3%). On 31 December 2022, the KRT prevalence was 2-fold (women: 2.2-fold, men: 1.9-fold) higher in the US (2444.2 pmp) than in Europe (1218.6 pmp). The proportion of women was lower in Europe (38%) than in the US (41%). The kidney transplantation rate was 1.7-fold higher in the US (79.1 pmp) than in Europe (45.4 pmp), 1.9-fold for women and 1.7-fold for men, with women accounting for 37% of the recipients versus 39% in the US. The KRT mortality rate was 1.5 times higher in the US (145.0 per 1000 patient years (/1000py)) compared to Europe (100.5/1000py): 1.6-fold for women and 1.4-fold for men. In Europe, mortality was lower for women receiving KRT (93.7/1000py) than for men (104.6/1000py), whereas in the US the reverse was (women: 148.9/1000py, men: 142.2/1000py). CONCLUSION The US had a notably higher KRT incidence, prevalence, kidney transplantation rate and mortality compared to Europe. Differences between Europe and the US were larger for women than for men.