Regional differences in renal replacement therapy in northern Norway 2000-2012

• Published in: International Journal of Circumpolar Health
• Main Authors: Norum, Jan, Leivestad, Torbjørn, Eriksen, Bjørn Odvar, Skår, Siw, Fagerheim, Anne Kristine, Reisæter, Anna Varberg
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2015
• Subjects: Norway; renal replacement therapy; subarctic; survival; VDP::Medical disciplines: 700::Clinical medical disciplines: 750; VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750; Circumpolar Health; Finnmark; International Journal of Circumpolar Health; Nordland; Northern Norway; Subarctic; Troms
• Online Access: https://hdl.handle.net/10037/8728; https://doi.org/10.3402/ijch.v74.24298

Published version, also available at http://dx.doi.org/10.3402/ijch.v74.24298 Objectives: Distance from residence location to a centre for renal replacement therapy (RRT) may influence patients’ quality of life and prognosis. Northern Norway constitutes 45% of Norway’s landmass, but has less than 10% of the population. Methods: In this study, we analysed all patients in northern Norway consecutively registered in the Norwegian Renal Registry during 20002012. A total of 634 patients (Nordland County 321 patients, Troms County 215 patients and Finnmark County 98 patients) were investigated. Results: There were more smokers (31% vs. 22%) and patients with diabetes (32% vs. 22%) in Finnmark, but the difference did not reach statistical significance. Patients undergoing RRT and living in Finnmark County had a significantly worse outcome (P0.03). The median survivals after initiation of RRT were 3.8 years (Finnmark), 6.4 years (Troms) and 5.4 years (Nordland), respectively. The most common causes of death were cardiovascular disease (53%), infections (16%), withdrawal from therapy (15%) and malignancy (13%). In a Cox analysis, age (PB0.0001), diabetes (P0.008) and smoking at any time (PB0.004) were individual factors correlated with inferior prognosis. Conclusion: Age, smoking and diabetes were prognostic factors. Residents of the northernmost county (Finnmark) experienced an inferior prognosis. Long distance from residence location to hospital may be another factor, but this could not be documented. Preventive strategies should be improved.