Is a rise in the prevalence of chronic conditions an inevitable consequence of better survival? Exploring variations in the prevalence of renal replacement therapy, and life expectancy in Europe, 2001-2011

Ronny Westerman, Federal Institute for Population Research (BiB)
Frederik Peters, Universität Rostock
Roland Rau, Universität Rostock

The progress in human survival throughout the past centuries marks a remarkable improvement in the average lifespan accompanied by a fundamental change in the composition of deaths. The aim of this paper is to explore the question whether higher life expectancy will ultimately lead to an expansion of the prevalence of chronic conditions. For this purpose we contrast changes in life expectancy with the prevalence and incidence of Renal Replacement therapy. Using data from the human mortality database, the ERA-EDTA registry and the WHO causes of death database, the prevalence of renal-replacement therapy (RRT) as proxy for ESRD, and partial life expectancy was computed for the age groups 0-74 and 75+. Our sample comprised males and females in Austria, Denmark, Finland, Greece, Netherlands, Norway, Sweden and Scotland in 2001-2011. Although the life expectancy has increased, the prevalence of RRT decreases in all countries both for males and females. However, larger changes in life expectancy were not necessarily linked to larger changes in the prevalence/incidence of RRT.