Simulation model of renal replacement therapy: predicting future demand in England

摘要: Background. The demand for renal replacement therapy (RRT) in England has risen steadily, although from a lower base than many other developed countries. Predicting the future RRT and impact of factors such as acceptance rate, transplant supply patient survival, is required order to inform planning services. Methods. A discrete event simulation model estimates 2010 range scenarios. uses current prevalence projected rates, survival rates transitions between modalities predict numbers. National population mortality data, published literature data UK Renal Registry Transplant, are used estimate unmet need RRT, changing demography incidence Type 2 diabetes, haemodialysis (HD) supply. Results. By predicted will have increased about 30 000 2000 42 51 (900–1000 p.m.p.), an average annual growth 4.5–6%. Changing small effect on overall numbers but changes proportion patients with functioning graft by up 8%. Even optimistic increase (11% p.a. 5 years), HD continue rise substantially, especially elderly. most influencing rate dialysis survival. Conclusion. This predicts substantial approaching 1000 p.m.p., particularly elderly those HD, steady state not being reached at least 25 years.