title: Evolution of the incidence of chronic kidney disease Stage 5 requiring renal replacement therapy in the diabetic population of Catalonia.
abstract: BACKGROUND
  Chronic kidney disease due to diabetes (DCKD) is the main known cause of renal replacement therapy (RRT) initiation. A Centers for Disease Control and Prevention study showed that the rate of DCKD cases initiating RRT among the overall DM population has dropped in the USA. Our main objective was to analyse this rate in Catalonia in 1994, 2002, 2006 and 2010. Cardiovascular risk factors (CVRF) in the diabetic population and characteristics and survival of DCKD patients on RRT were also evaluated.
  
  
  METHODS
  Data from the Catalan Renal Registry was used to learn the number of DCKD cases on RRT together with their characteristics and survival rates. Data from the Catalonia Health Survey established the diabetic population and also the prevalence of CVRF in this population.
  
  
  RESULTS
  The adjusted rate (95% CI) of patients initiating RRT with DCKD was 509.1 (484.6-533.7) pmp in 1994, 645.3 (621.6-669.0) in 2002, 602.6 (581.4-623.9) in 2006 and 600.0 (578.4-621.6) in 2010. Survival of DCKD patients in the 4th year of RRT had increased progressively from 35.9% for DCKD cases versus 64.9% for CKD cases due to other causes in 1994, to 39.9% versus 58.3% in 2002 and to 59.9% versus 65.9% in 2006.
  
  
  CONCLUSIONS
  Since 2002, the rates of patients with DCKD initiating RRT among the overall DM population decreased slightly in Catalonia. Survival in these cases has increased progressively and in 2006 is similar to the CKD patients due to other causes. This figure suggests a better overall management, especially of CVRF.
authors.affiliation: Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain. jcomas@catsalut.cat
authors.forename: Jordi
authors.initials: J
authors.lastname: Comas
authors.forename: Emma
authors.initials: E
authors.lastname: Arcos
authors.forename: Conxa
authors.initials: C
authors.lastname: Castell
authors.forename: Aleix
authors.initials: A
authors.lastname: Cases
authors.forename: Albert
authors.initials: A
authors.lastname: Martínez-Castelao
authors.forename: Teresa
authors.initials: T
authors.lastname: Doñate
authors.forename: Enric
authors.initials: E
authors.lastname: Esmatjes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D048909:Diabetes Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017582:Renal Replacement Therapy / Q000401:mortality*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D055815:Young Adult
keywords: cardiovascular risk factors; diabetic nephropathy; end-stage renal disease; renal replacement therapy; survival