title: Estimation of expected life-years saved from successful prevention of end-stage renal disease in elderly patients with diabetes: a nationwide study from Taiwan.
abstract: OBJECTIVE
  Because of the increasing incidence and prevalence of diabetes as a leading cause of end-stage renal disease (ESRD) in the aging population, we estimated the expected life-years (LYs) saved from successful prevention of ESRD in elderly patients with diabetes.
  
  
  METHODS
  We conducted a population-based cohort study using the National Health Insurance Research Database. We identified all incidences of ESRD in the individuals >65 years of age who were receiving maintenance hemodialysis (N = 24,243) from the registry files of catastrophic illnesses in Taiwan from 1 July 1997 to 31 December 2005. We then retrospectively searched the database to determine whether there had been a diagnosis of diabetes in these cases. After the exclusion of individuals with malignancy (n = 3,423), we extrapolated the survival rates through the end of 2006 using the Monte Carlo method. Using the data of preventable ESRD cases due to diabetes and expected years of life lost (EYLL) in each age stratum, we further estimated the expected LYs saved from successful prevention of ESRD in elderly patients with diabetes.
  
  
  RESULTS
  The estimated average EYLL was 10.6-5.8 and 12.3-7.3 years for diabetic males and females, respectively, aged 65-79 years. In total, 5,430.1 LYs and 10,177 LYs could be saved by the successful prevention of ESRD in male and female elderly patients with diabetes, respectively, in a single year.
  
  
  CONCLUSIONS
  The LYs saved by successful prevention of ESRD in elderly patients with diabetes in a single year are substantial and deserve special attention, especially in elderly females.
authors.affiliation: Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Deng-Chi
authors.initials: DC
authors.lastname: Yang
authors.forename: Lukas Jyuhn-Hsiarn
authors.initials: LJ
authors.lastname: Lee
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsu
authors.forename: Yu-Yin
authors.initials: YY
authors.lastname: Chang
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Wang
authors.forename: Wei-Hung
authors.initials: WH
authors.lastname: Lin
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
mesh_terms: D000368:Aged; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality*; D008297:Male; D015996:Survival Rate; D013624:Taiwan