1 Adult Hemodialysis Longitudinal Follow-Up Data 2002–2008

1

Adult Hemodialysis Longitudinal Follow-Up

Data 2002–2008

2

Developed for Dr. Louise Moist, President Canadian Organ Replacement Register, Inc.

Originally presented atCanadian Society of Nephrology Annual Conference May 2010

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2002 2005 20080%

20%

40%

60%

80%

100%

75% 77% 81%

16%

Catheters AV Fistula AV Graft Unknown

Incident Vascular Access Type, Canada, Select Years

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

4

Incident Vascular Access Type by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

100%

66%

90%

Catheters AV Fistula AV Graft UnknownSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

5

Prevalent Vascular Access Type, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

37%46% 51%

51%47%

44%

12% 7% 5%

Catheters AV Fistula AV Graft UnknownSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

6

Prevalent Vascular Access Type by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

36%

46%

39%

52%55%

48%

40%36%

62%

51%

Catheters AV Fistula AV Graft Unknown

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

Kt/V Ranges in Adult Hemodialysis Patientsby Province, 2008

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B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

56%

17%

Less Than 1.2 1.2–2.0 Greater Than 2.0Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

8

Hemoglobin Ranges in Adult Hemodialysis Patients, Canada, Select Years

Series10%

20%

40%

60%

80%

100%

48% 48%

58%

39% 41%28%

Less Than 100 g/L 100–120 g/L Greater Than 120 g/LSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

9

Hemoglobin Ranges in Adult Hemodialysis Patients by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

45%

14%

30% 29% 29% 28% 30%28%

25%28%

Less Than 100 g/L 100–120 g/L Greater Than 120 g/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

10

ESA Usage in Adult Hemodialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

89% 93% 91%

Erythropoietin No Erythropoietin UnknownSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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ESA Usage in Adult Hemodialysis Patients by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

100%93%

86%92% 92% 91% 91%

82%

98%

90% 91%

Erythropoietin No Erythropoietin UnknownSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

12

Ferritin Levels in Adult Hemodialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

21% 16% 16%

69%71% 71%

Less Than 100 ng/mL 100–800 ng/mL Greater Than 800 ng/mL

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

13

Route of Iron Administration Among Adult Hemodialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

18%11% 9%

48%54%

43%

Oral Iron Intravenous Iron No/UnknownSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Route of Iron Administration Among Adult Hemodialysis Patients by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

100%

82%76% 74%

58%

33%39%

64%

78%

35%

43%

Oral Iron Intravenous Iron No/UnknownSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Corrected Calcium Levels in Adult Hemodialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

74%78% 79%

Less Than 2.1 mmol/L 2.1–2.54 mmol/L Greater Than 2.54 mmol/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Corrected Calcium Levels in Adult Hemodialysis Patients by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

100%

81% 80%77% 76%

78%83%

69%73%

77% 79%

Less Than 2.1 mmol/L 2.1–2.54 mmol/L Greater Than 2.54 mmol/LSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Phosphate Levels in Adult Hemodialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

15 % 17 % 16 %

45 %49 % 50 %

40% 35% 34%

Less Than 1.13 mmol/L 1.13–1.78 mmol/L Greater Than 1.78 mmol/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Phosphate Levels in Adult Hemodialysis Patients by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

10%

20%

30%

40%

50%

60%

70%

33 %

44 % 45 % 45 %

33 %

25 %

54 %

49 %

31 %34 %

Less Than 1.13 mmol/L 1.13–1.78 mmol/L Greater Than 1.78 mmol/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Parathyroid Hormone Levels in Adult Hemodialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

53%40%

30%

23%

27%

28%

24%33%

42%

Less Than 16.5 pmol/L 16.5–33.0 pmol/L Greater Than 33.0 pmol/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Parathyroid Hormone Levels in Adult Hemodialysis Patients by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

10%

20%

30%

40%

50%

60%

50 %

40 % 41 %39 %

43 % 42 %43 %

48 %

38 %

42 %

Less Than 16.5 pmol/L 16.5–33.0 pmol/L Greater Than 33.0 pmol/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Number of Mineral Metabolism Measures in Target Range, Canada by Year

2002 2005 20080%

20%

40%

60%

80%

100%

12% 10% 9%

43%39% 37%

37%41% 41%

8% 11% 13%

None One Two ThreeSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Number of Mineral Metabolism Measures in Target Range by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

10%

20%

30%

40%

50%

14%12% 13% 13% 11%

16%

7%9%

16%13%

None One Two Three

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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HbA1C Levels Among Adult Diabetics on Hemodialysis, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

62 % 64 % 67 %

Less Than 7% Greater Than or Equal To 7%

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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HbA1C Levels Among Adult Diabetics on Hemodialysis by Province, 2008

B.C. Alta. Sask. Man. Ont. Que. N.L. N.S. N.B. Canada0%

20%

40%

60%

80%

66 % 65 % 66 %

57 %

68 %70 %

66 % 65 %

75 %

67 %

Less Than 7% Greater Than or Equal To 7%

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Weekly Kt/V Levels in Adult Peritoneal Dialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

11 %13 %

20 %

57 % 52 %

54 %

<1.7 1.7-2.0 >2.0 Not yet assessed Not rountinely measured

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Hemoglobin Level in Adult Peritoneal Dialysis Patients, Canada, Select Years

2002 2005 20080%

20%

40%

60%

80%

100%

10 % 9 % 14 %

45 % 45 %

55 %

45 % 46 %

32 %

<100g/L 100-120 g/L >120+g/LSource Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.

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Hemoglobin Levels in Adult Peritoneal Dialysis Patients by Province, 2008

BC AB SK MB ON QC NB NS NL Canada0%

10%

20%

30%

40%

50%

60%

70%

38%

25%28%

31% 30%

40%

33%

45% 47%

32%

<100g/L 100-120 g/L >120+g/L

Source Canadian Organ Replacement Register, 2010, Canadian Institute for Health Information.