End-stage renal disease and survival in people with diabetes: a national database linkage study

被引:54
作者
Bell, S. [1 ]
Fletcher, E. H. [2 ]
Brady, I. [2 ]
Looker, H. C. [2 ]
Levin, D. [2 ]
Joss, N. [3 ]
Traynor, J. P. [4 ]
Metcalfe, W. [4 ]
Conway, B. [5 ]
Livingstone, S. [2 ]
Leese, G. [6 ]
Philip, S. [7 ]
Wild, S. [8 ]
Halbesma, N. [8 ]
Sattar, N. [9 ]
Lindsay, R. S. [9 ]
Mcknight, J. [10 ]
Pearson, D. [11 ]
Colhoun, H. M. [2 ]
机构
[1] Ninewells Hosp, NHS Tayside, Renal Unit, Dundee DD1 9SY, Scotland
[2] Univ Dundee, Diabet Epidemiol Unit, Dundee DD2 4BF, Scotland
[3] Raigmore Hosp, NHS Highland, Inverness IV2 3UJ, Scotland
[4] Scottish Renal Registry, Abbotsinch Paisley PA3 2SJ, Scotland
[5] Univ Edinburgh, Queens Med Res Inst, Ctr Cardiovasc Sci, Edinburgh EH16 4TJ, Midlothian, Scotland
[6] Univ Dundee, Ninewells Hosp & Med Sch, Scottish Diabet Res Network, Dundee DD1 9SY, Scotland
[7] Woolmanhill Hosp, Grampian Diabet Res Unit, Aberdeen AB25 1LD, Scotland
[8] Univ Edinburgh, Ctr Populat Hlth Sci, Edinburgh EH8 9AG, Midlothian, Scotland
[9] Univ Glasgow, BHF Glasgow Cardiovasc Res Ctr, Glasgow G12 8TA, Lanark, Scotland
[10] Western Gen Hosp, Metab Unit, Edinburgh EH4 2XU, Midlothian, Scotland
[11] Aberdeen Royal Infirm, NHS Grampian, Aberdeen AB15 6XS, Scotland
基金
英国惠康基金;
关键词
REPLACEMENT THERAPY; PREVALENCE; REGISTRY; COMPLICATIONS; EPIDEMIOLOGY; NEPHROPATHY; DIALYSIS; DEATH; IDDM;
D O I
10.1093/qjmed/hcu170
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Increasing prevalence of diabetes worldwide is projected to lead to an increase in patients with end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). Aim: To provide contemporary estimates of the prevalence of ESRD and requirement for RRT among people with diabetes in a nationwide study and to report associated survival. Methods: Data were extracted and linked from three national databases: Scottish Renal Registry, Scottish Care Initiative-Diabetes Collaboration and National Records of Scotland death data. Survival analyses were modelled with Cox regression. Results: Point prevalence of chronic kidney disease (CKD) 5 in 2008 was 1.63% of 19 414 people with type 1 diabetes (T1DM) compared with 0.58% of 167 871 people with type 2 diabetes (T2DM) (odds ratio for DM type 0.97, P=0.77, on adjustment for duration. Although 83% of those with T1DM and CKD5 and 61% of those with T2DM and CKD5 were receiving RRT, there was no difference when adjusted for age, sex and DM duration (odds ratio for DM type 0.83, P = 0.432). Diabetic nephropathy was the primary renal diagnosis in 91% of people with T1DM and 58% of people with T2DM on RRT. Median survival time from initiation of RRT was 3.84 years (95% CI 2.77, 4.62) in T1DM and 2.16 years (95% CI: 1.92, 2.38) in T2DM. Conclusion: Considerable numbers of patients with diabetes continue to progress to CKD5 and RRT. Almost half of all RRT cases in T2DM are considered to be due to conditions other than diabetic nephropathy. Median survival time for people with diabetes from initiation of RRT remains poor. These prevalence data are important for future resource planning.
引用
收藏
页码:127 / 134
页数:8
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