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Diabetes Care. 2018 Mar;41(3):434-439. doi: 10.2337/dc17-2364. Epub 2017 Dec 20.

Incidence of End-Stage Renal Disease in Patients With Type 1 Diabetes.

Author information

1
Finnish Registry for Kidney Diseases, Helsinki, Finland jaakko.helve@helsinki.fi.
2
Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
3
Department of Social Research, Centre for Research Methods, University of Helsinki, Helsinki, Finland.
4
Insitute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
5
National Institute for Health and Welfare, Helsinki, Finland.
6
Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.
7
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland.
8
Finnish Registry for Kidney Diseases, Helsinki, Finland.
9
Baker IDI Heart & Diabetes Institute, Melbourne, Australia.

Abstract

OBJECTIVE:

To investigate how risk of end-stage renal disease (ESRD) among patients with type 1 diabetes has changed over time and further how the risk is affected by age, sex, and time period of diagnosis of diabetes.

RESEARCH DESIGN AND METHODS:

A cohort including all patients <30 years old diagnosed with type 1 diabetes in Finland in 1965-2011 was followed until start of renal replacement therapy, death, or end of follow-up at the end of 2013. Altogether, 29,906 patients were included. The main outcome was cumulative risk of ESRD, accounting for death as a competing risk.

RESULTS:

The patients were followed up for a median of 20 years. During 616,403 patient-years, 1,543 ESRD cases and 4,185 deaths were recorded. The cumulative risk of ESRD was 2.2% after 20 years and 7.0% after 30 years from the diabetes diagnosis. The relative risk of ESRD was 0.13 (95% CI 0.08-0.22) among patients diagnosed in 1995-2011 compared with those diagnosed in 1965-1979. Patients <5 years old at the time of diagnosis had the lowest risk of ESRD after diagnosis. With the cumulative risk of ESRD estimated from time of birth, the patients aged 5-9 years at diabetes diagnosis were at highest risk.

CONCLUSIONS:

The cumulative risk of ESRD has decreased markedly during the past five decades. This highlights the importance of modern treatment of diabetes and diabetic nephropathy.

PMID:
29263163
DOI:
10.2337/dc17-2364
[Indexed for MEDLINE]

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