Nephrology Dialysis Transplantation, Vol 12, Issue 12 2501-2509, Copyright © 1997 by Oxford University Press
J Rodriguez, M Cleries, E Vela and R Registry Committee
Purpose of study; In recent years, a progressive
increase in the need of renal replacement therapy has been noted for
patients with diabetes mellitus. The present report is based on an analysis
of the data of the 'Registre de Malats Renals de Catalunya' (RMRC). It was
the aim to identify (I) the incidence and prevalence of diabetic patients
on renal replacement therapy, (ii) associated diseases, (iii) the relative
risk of different modes of treatment, and (iv) the rate of death compared
to non-diabetic patients on renal replacement therapy and in the general
population. Results: Of the 936 diabetic patients
starting renal replacement therapy during the period 1984-1994, 24.8% were
classified as DN and IDDM, 65.7% as DN and NIDDM, and in 9.5%, diabetes
accompanied renal failure from standard primary renal disease. The
incidence of diabetic patients has increased from 3 per million population
(pmp) in 1984 to 26.6 pmp in 1994. At any given age the risk of requiring
renal replacement therapy with diabetes was 1.5-fold higher in males than
in females. Of diabetic patients who were <45 years of age, 55%
received a renal transplant and >50% lived with a simultaneous
kidney/pancreas graft. For diabetic patients above this age, haemodialysis
was the most prevalent form of treatment. Morbidity in diabetic patients
was higher than in the overall RMRC population. Cardiac and vascular
disease were the most prominent complications. Mortality of diabetic
patients on renal replacement therapy was twice that of the overall
population of RMRC and 16-fold higher than in the general population of
Catalunya. The risk of death increased with age and was higher in patients
with reduced functional autonomy. Transplanted patients had a smaller risk
than patients on haemodialysis or CAPD. Survival has increased for patients
starting treatment after 1990 compared to the period 1984-1989.
Conclusion: In conclusion, diabetes mellitus is one of
the main causes leading to renal replacement therapy in Catulunya. Diabetic
patients are more multimorbid than the rest of the population of the
Registre d Malats Renals de Catalunya. These observations call for the
institution of primary or secondary prevention. Key
words: diabetes mellitus; multivariate analysis; renal registry;
renal replacement therapy
DIALYSIS AND TRANSPLANTATION NEWS
Diabetic patients on renal replacement therapy: analysis of Catalan registry data
Hospital General de la Vall d'Hebron, Spain; Catalan Health Service, Catalonia, Spain; Corresponding author at; Registre de Malalts Renals de Catalunya, Servei Catala de la Salut, Travessear de les Corts, 131-159 ed. Olimpia, 08028 Barcelona, Spain
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