137 patients were actively treated because of chronic uremia, during 1966 to 1977 in the city of Göteborg. One year patient survival increased from 51% (1966 to 1968) to 81% (1975 to 1977). Peritoneal dialysis decreased as the initial mode of treatment, and only 3% of the patients started dialysis treatment with this mode of therapy in the last 3-year period. Mean age of the actively treated patients was 44 years. A decreasing mean age of the actively treated patients was found towards the end of the period, reflecting more liberal criteria for accepting young patients with different systemic diseases. If the initial mode of treatment was dialysis, 1-year patient survival in the last 3-year period was 77%.
The role of paid work in chronic illness has been investigated in this nation-wide study of all Swedish-speaking patients on chronic dialysis above the age of 16 years, who were not too tired or severely ill to participate and who had been treated for at least 3 months. Young age and female gender were consistently associated with increased prevalence of self-reported depression, poor psychological health, psychosomatic symptoms and sleep disturbance. In multivariate analyses paid work, strong emotional support, and care at intermediate or small units were independently associated with a good quality of life. Chronic dialysis patients who did paid work (19.6% of the patients below 65 years of age) perceived their work as more socially supportive than did men and women in the normal working population. It may be concluded that paid work is of particular importance to this patient group because it may give extra social support to patients whose social network is in general rather poor.
OBJECTIVE: The Swedish Registry for Active Treatment of Uraemia (SRAU) was founded in 1991 with the objective of documenting demographic data on patients treated for end-stage renal disease (ESRD). The aim of this study was to describe the prevalence, incidence, comorbidity risk factors and survival of patients with ESRD who underwent dialysis treatment and/ or kidney transplantation in Sweden between 1991 and 2002. MATERIAL AND METHODS: All dialysis and transplant units (n = 65) presently report to the SRAU and almost all patients are reported and followed until death. RESULTS: The prevalence of patients on dialysis and transplantation, being approximately 750 per million population (PMP), has increased by 75% in 12 years. The recent annual rise is approximately 3% (200 patients). The incidence has been stable since 1997 at approximately 125 patients PMP. In 2002, there were 1113 new patients, the majority of whom were aged > or =65 years. Their original kidney disease was most often diabetic nephropathy (23.7%), with nephrosclerosis (19.0%) being the second most common disease. The total number of renal transplantations performed has decreased to some extent. The overall 5-year patient survival rate was 23.1% in patients on dialysis and 85.5% after kidney transplantation. The major cause of death was cardiovascular disease (48%) and an increasing frequency of malignancy after transplantation (26%) was noted. CONCLUSION: The prevalence of ESRD has nearly doubled since 1990 and the number of new patients being referred for dialysis has increased. These patients are becoming older, with a large proportion having non-renal complicating diseases. Survival after transplantation was excellent. The shortage of cadaveric donors in Sweden in recent years and increasing mortality from malignant disease after transplantation are issues of great concern.
In a double-blind trial of hospital staff members at risk of contracting hepatitis B, 110 subjects received hepatitis B immune globulin or immune serum globulin prophylactically. An additional 125 individuals working in the same locations were unwilling to participate in the trial and received no prophylaxis. During the study period of 28 months, 13 cases of clinical hepatitis B occurred in the untreated group, whereas only three cases occurred among the subjects who received prophylaxis.