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Rowan Walker – Chairman 2000 -2007
Chair: Steve Chadban• ANZDATA update (Stephen McDonald)• Analgaesic nephropathy – the end of an epidemic?
(Sean Chang)• Haemodialysis access -- recent changes (Kevan
Polkinghorne)• Living kidney donor Registry (Steve Chadban)• APD vs CAPD (David Johnson)• HD vs PD in children (Stephen McDonald)
ANZDATA update
Stephen McDonald PhD FRACP
Executive Officer, ANZDATA Registry
Summary
• Real-time data entry– Evolution of Web-based data entry
• Web-site
• People
• Centre reports
• Potential future developments
• ESKD trends
Real-time data entry
• Key development in recent years– Structure remains unchanged– Reporting by web or paper
• New patients• Transplants• Transplant failure
– Events reported as they occur
– Facilitates real-time reporting• Monthly interim summaries
distributed
SURNAME Given Names SEXDATE OF BIRTH
POSTCODE AT ENTRY COUNTRY OF BIRTH (If Australia or NZ - Tick box)
OTHER COUNTRY (Please specify)AUST NZ
CO-MORBID CONDITIONS AT ENTRY
LATE REFERRAL <3 MTHSBEFORE FIRST
TREATMENT(Y/N)
HEIGHT (cms) WEIGHT (kg) CIGARETTE SMOKING
N=NeverF=FormerC=Current
Anzdata RegistryReal Time Entry Form
COMMENTS
K EY EVENTS (fill in at time of occurrence for transplants, graft failures and deaths)
FAX TO ANZDATA (08) 8222.6795
OtherGRAFT FAILURE (DATE)
NEW PATIENT (DATA AT INITIAL TREATMENT)
DATE & MODE OF FIRST TREATMENT
Record from List
Code Day Month Year
TO Name of Hospital
Date of TransferName of Hospital
FROM
INITIAL HOSPITAL CURRENT PARENT HOSPITALHospital/State Hospital/StateHosp. Unit No. Hosp. Unit No Physician
SE. CREATININEBIOPSY Y/NAT ENTRY
RACIAL ORIGIN - Record from list PRIMARY RENAL DISEASE - Record from list
OtherOther
ACCESS
AT 1ST HD
1=Native2= Synthetic3=Tunnel CVC4=Non Tunnel CVC
OtherTRANSPLANT (Date) DONOR SOURCE - Record from list
For Code 8 and 14 Specify other related or un-related donor
Transplanting Unit
DIABETES
N=NoO=Type 1 Insulin dependentP=Type 2 Non Insulin requiringQ=Type 2 Insulin requiring
CHRONIC LUNG CORONARY ARTERY PERIPHERAL VASC.
CEREBROVASC.
Y=YesS=SuspectedN=No
3 9 2007 RTD Form.ppt
DEATH (DATE) CAUSE OF DEATH – Record from listOther
Caring HospitalAt Death
PATIENT TRANSFER
If Pre-eptive Transplantsupply Transplanting Unit and Donor Source in “Key Events” below
PATIENT IDENTITY
REGISTRY No.
Web-based systems
• Web-based data entry• Web-based data interrogation systems
Export options
Website
People
• Biostatistician
• Epidemiology Fellow
• Visitors
• Opportunities– Working groups– Steering committee
Potential future developments
• Relocation of ANZDATA
• Recommendations of National Clinical Taskforce on Organ and Tissue Donation awaited late 2007– Transplant outcome registries a specific focus
Centre reports
• Changes planned– Identification of best-performing units– Format– Continue to report relevant outcome against agreed
benchmarks / CARI targets
• Exploration of adjustment for patient characteristics– Presently use restriction as approach to confounding
• Exploration of cusum graphic approach to presentation of results
What is cusum?-1
0-5
05
Cum
ula
tive
sum
O-E
01jan2000 01jul2001 01jan2003 01jul2004 01jan2006
Tx date
Cusum graft failure at 1 year
Example
-2
0
2
4
6
Cum
ula
tive
sum
O-E
01jan
2000
01jul
2001
01jan
2003
01jul
2004
01jan
2006
Tx date
Cusum graft failure at 1 year
Key ESKD data
• Barbecue-level information
Current state of play
• As at 31 Dec 2006 there were– In Australia
• 16041 people receiving some form of kidney replacement therapy
– 9180 people receiving dialysis treatment– 6861 with a functioning transplant– 3 fold increase over past 15 years
• New patient rate 115 per million per year
– In New Zealand• 3212 people in New Zealand receiving some form of kidney
replacement therapy– 1977 people receiving dialysis treatment
• New patient rate 117 per million per year
New patients
Australia new RRT patients. Linear increase 5.4% year on year
20
40
60
80
100
120
Inci
dent
ra
te (
pm
py)
1970 1975 1980 1985 1990 1995 2000 2005 2010Year of first treatment
New Patient Rates
70
80
90
100
110
120
130
Inci
dent
RR
T r
ate
(p
er m
illio
n p
er y
ear)
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006Year
Australia NZ
Age-specific rates
Australian RRT incidence rates by age at start
0
50
100
150
200
250
300
350
400
450
500
19
71
19
73
19
75
19
77
19
79
19
81
19
83
19
85
19
87
19
89
19
91
19
93
19
95
19
97
19
99
20
01
20
03
20
05
Year
Ra
te p
er
mill
ion
0-
5-
15-
25-
35-
45-
55-
65-
75-
85-
Transplant numbers
0
200
400
600
0
50
100
150
199
01
991
199
21
993
199
41
995
199
61
997
199
81
999
200
02
001
200
22
003
200
42
005
200
6
199
01
991
199
21
993
199
41
995
199
61
997
199
81
999
200
02
001
200
22
003
200
42
005
200
6Australia New Zealand
Cadaveric Live related Live unrelatedDonor source
Num
ber
ANZDATA, Tx numbers by year and source
Prevalent patients – treatment
Australia New Zealand
APD CAPDHospital HD Satellite HD
Home HD Graft
Data for prevalent patients 31 Dec 2006; ANZDATA Registry
Prevalent patients – trends
0
5,000
10,000
15,000
Num
ber
199
0
199
1
199
2
199
3
199
4
199
5
199
6
199
7
199
8
199
9
200
0
200
1
200
2
200
3
200
4
200
5
200
6
Australia
APD CAPDHospital HD Satellite HDHome HD Graft
Prevalent patients (NZ) - trends
0
1,000
2,000
3,000
Num
ber
199
0
199
1
199
2
199
3
199
4
199
5
199
6
199
7
199
8
199
9
200
0
200
1
200
2
200
3
200
4
200
5
200
6
New Zealand
APD CAPDHospital HD Satellite HDHome HD Graft
Prevalent patients – treatment
0
20
40
60
80
100
Pe
rcen
t
NT
NS
W/A
CT
Vic
Qld
SA
WA
Tas
NZ
APD CAPDHospital HD Satellite HDHome HD Graft
Thankyou