Geographical aspects of the uptake of renal replacement therapy in England

The National Renal Review provides a complete picture of new patients treated by renal replacement therapy (RRT) in England in 1991-92. RRT is a lifesaving treatment for patients with endstage renal failure. This paper describes an analysis of the review data using multilevel modelling to assess the effects of age, sex, ethnicity, deprivation, access and supply factors on acceptance onto RRT. In particular, we focus on the additional effect of deprivation, access and supply when the basic population factors are taken into account. After a summary of the results of national modelling, a series of models for Greater London, Metropolitan and non-Metropolitan areas are presented, which examine the variations in these factors by area type.