DISCONTINUATION OF TREATMENT AMONG ITALIAN DIABETIC-PATIENTS TREATED BY RENAL REPLACEMENT THERAPY

Death from dialysis termination has been extensively surveyed in Canada, the United States, and Australia. In the US old age and the presence of diabetes has been associated with treatment withdrawal. On the other hand, information for Europe is very scarce. We addressed the issue of dialysis termination in Italy in both a cohort of diabetic patients starting RRT in 1987, and two age-, sex-, type of RRT, and unit-matched cohorts of diabetic and non-diabetic patients alive on RRT treatment on 31 December 1987. Follow-up was available till 31 December 1991. Dialysis termination accounted for 1.1% of the known causes of death in the incident diabetic cohort and for only 0.5% and 0.9% of the prevalent diabetic and non-diabetic cohorts respectively. In Italy, diabetes is not associated with higher rates of dialysis termination and this cause of death seems uncommon among the overall Italian RRT population. We cannot, however, exclude a predialysis selection against patients presenting with an old age or comorbid conditions.