[Epidemiologic analysis of the incidence of new diabetic patients on dialysis as a basis for a clinical study].
BACKGROUND
Aim of this study is to analyse the incidence of diabetic patients starting dialysis in Piedmont (Italy) during the period 1981-1996 and to evaluate, in a subgroup of patients, the causes of uremia (diabetic nephropathy or other), and the type and seriousness of comorbid factors, in order to define the clinical conditions and try to explain the causes incidence increase.


METHODS
Data are taken from the RPDT (Regional Registry of Dialysis and Transplantation of Piedmont).


RESULTS
Total incidence of new patients starting dialysis in this Region increased from 65 pmp in 1981-1982 to 116 pmp in 1995-1996 and the mean age increased from 55.4 +/- 15.5 years in 1981-1982 to 61.5 +/- 15.6 in 1995-1996; 49% of patients had at least one of the 13 conditions of comorbidity considered by the Registry (including severe vascular, cardiac, systemic diseases and diabetes). In the same period the incidence of diabetic patients increased from 6 pmp (1981-1982) to 19 for males and 12 pmp for females (1995-1996); this increase is higher for males and limited to patients with age > or = 60 years (for example: group 70-79 years from 7 to 56 pmp). A study performed in a group of 64 patients (52 type 2 and 12 type 1) showed the incidence of multiple comorbid factors: the most important in type 2 are vascular diseases (44/52) and heart diseases (20/52); blindness and amputations are relatively rare (2 each). An important comorbid factor in type 1 diabetes is blindness (3/12) and in this group the most frequent cause of uremia is diabetic nephropathy (DN) (9/12); in the group of type 2 patients nephroangiosclerosis and a clinical picture of progressive renal failure, without nephrotic syndrome, represents 48% of all diagnoses.


CONCLUSIONS
These results underline the necessity of a strict collaboration with diabetologists and of an improvement of dedicated structures in order to meet the increase of this critical population.
Cattedra di Nefrologia, Università degli Studi, Torino.
M
M
Ferro
G B
GB
Piccoli
M
M
Burdese
A M
AM
Iadarola
P
P
Anania
S
S
Giunti
M
M
Gai
M
M
Salomone
G
G
Triolo
F
F
Quarello
U
U
Malcangi
G
G
Piccoli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data*