UK Renal Registry 18th Annual Report: Chapter 6 Comorbidities and Current Smoking Status amongst Patients starting Renal Replacement Therapy in England, Wales and Northern Ireland from 2013 to 2014

Data on comorbidity at the time of start of renal replacement therapy (RRT) were submitted to the UK Renal Registry (UKRR) for 7,786 (58.1%) incident patients between 2013 and 2014. In 2014, 11 centres provided data on 100% of new patients and eight provided data for less than 5% of new patients, highlighting the continued wide variation in the completeness of data returns. In 2014, comorbidity data completeness in Wales and Northern Ireland was around 90% compared with 53% in England. In patients with comorbidity data, about half (49.8%) had one or more comorbidities and in the subgroup of patients aged 565 years, this increased to 63.1%. Diabetes mellitus (listed as primary renal disease or comorbidity) and ischaemic heart disease were the most common comorbid conditions, observed in 36% and 20% of patients respectively. Most comorbid conditions were more prevalent in patients aged 565 years, but the prevalence rates for ischaemic heart disease and malignancy were substantially higher than the rest. In 2013–2014, 12.5% of incident RRT patients were recorded as being smokers at initiation of dialysis; this is a decrease from 14% in the previous two years (2011–2012). Amongst incident RRT patients of White origin, the prevalence of having at least one comorbid condition was approximately 14% and 7% higher than in incident patients of Black and South Asian origin, respectively. There was a higher prevalence of ischaemic heart disease and peripheral vascular disease in patients referred early to a nephrologist than amongst patients referred late. Malignancy was much more common in patients who were referred late.