Renal replacement therapy for diabetic end-stage renal disease: data from 10 registries in Europe (1991-2000).
BACKGROUND
There is concern about the rising prevalence of type 2 diabetes mellitus and of the resultant nephropathy. This study uses data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry to provide information on the epidemiology and outcome of renal replacement therapy (RRT) for end-stage renal disease (ESRD) due to diabetic nephropathy (DN).


METHODS
Data from the following 10 registries: Austria, French-speaking Belgium, Denmark, Finland, Greece, Norway, Scotland (UK), Catalonia (Spain), Sweden, and The Netherlands were combined. Average annual changes (%) were estimated by Poisson regression. Analyses of mortality were performed by Cox regression.


RESULTS
An increase in patients with type 2 DN entering RRT has been observed (+11.9% annually, P < 0.05), while large differences in RRT incidence in this disease continue to exist between countries in Europe. There was a reduction in mortality during the first 2 years on dialysis therapy among patients with type 2 DN (AHR 0.96, 95%CI 0.94-0.97 annually). The mortality among transplant recipients decreased for both type 1 DN and nondiabetic ESRD (non DN) within the 1995-1998 cohort (type 1 DN: AHR 0.49, 95% CI 0.35-0.68; non DN: AHR 0.79, 95% CI 0.69-0.90) compared to the 1991-1994 cohort.


CONCLUSIONS
This report has shown that during the last decade there has been a marked increase in the incidence of RRT for type 2 DN. Survival analysis showed that over the period 1991-1999 the mortality rates of all dialysis patients and of type 1 diabetic and nondiabetic renal transplant recipients have fallen.
Van Dijk
Paul C W
PC
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands. erareg@amc.uva.nl
Jager
Kitty J
KJ
Stengel
Bénédicte
B
Grönhagen-Riska
Carola
C
Feest
Terry G
TG
Briggs
J Douglas
JD
D017677:Age Distribution; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D012042:Registries; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data*