title: Incidence of end stage renal disease among type 1 diabetes: a nationwide cohort study in Taiwan.
abstract: The aim of our study was to estimate the risk of end-stage renal disease (ESRD) in type 1 diabetes mellitus (T1DM) in Taiwanese people; in addition, our goal was to determine how the age, year, and sex at registration of T1DM affects the risk. Population-based cohort study. A nationwide cohort study of 7203 Taiwanese patients with T1DM registered in 1999 to 2010 was followed up until ESRD, death, or the end of follow-up on December 31, 2010. Annual age-, sex-, and calendar year-specific incidence rates of ESRD of the general population were used to calculate the standardized incidence ratio (SIR) of ESRD in relation to T1DM. The SIR of ESRD for male and female patients with T1DM was significantly increased at 25.85 (95% CI 23.40-28.29) and 28.08 (95% 25.45-30.71), respectively; the peak was at age 15 to 29 years for both genders. The cumulative incidence of ESRD was similar in male and female patients but was significantly higher in patients≥ 30 years old than in patients<30 years old (10.25% vs. 3.57%, P<0.001). Patients aged <15 years had a significantly lower risk of ESRD as compared to those aged 15 to 29 years; patients aged 30 to 44 (adjusted HR, 1.491) and 45 to 60 years (adjusted HR, 2.111) showed significantly increased hazards. Our data also demonstrated a lower risk of ESRD in patients who were registered in later years than in earlier years. The risk of ESRD is substantially increased in T1DM in the ethnic Chinese population. The continuously declining risk of ESRD in T1DM may advocate the use of a multidisciplinary chronic kidney disease care system in Taiwan.
authors.affiliation: From the Institute of Clinical Medicine, College of Medicine, National Cheng Kung University (WHL), Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University (WHL, DCY, THK, MCW), Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University (CYL, THK), Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine (WMW), Institute of Gerontology, College of Medicine, National Cheng Kung University (DCY), Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University (MCW) Tainan; and Department of Public Health, College of Public Health, China Medical University (CYL) Taichung, Taiwan.
authors.forename: Wei-Hung
authors.initials: WH
authors.lastname: Lin
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Wang
authors.forename: Deng-Chi
authors.initials: DC
authors.lastname: Yang
authors.forename: Te-Hui
authors.initials: TH
authors.lastname: Kuo
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult