title: Diabetes-related end-stage renal disease in Austria 1965-2013.
abstract: BACKGROUND
  Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) in Austria, accounting for a high burden of morbidity and mortality. In this nationwide study, we aimed to evaluate the incidence and fate of patients with DKD-ESRD over time.
  
  
  METHODS
  Data (collected annually) from the Austrian Dialysis- and Transplant Registry were analysed for the development of ESRD due to DKD from 1965 to 2013.
  
  
  RESULTS
  Over 48 years, 8322 and 22 975 patients with ESRD due to diabetes and non-diabetes, respectively, entered dialysis. While DKD-ESRD-patients were not dialysed until 1974, in 1975 seven type 1- and one type 2-diabetics started dialysis (1.06 per million population-PMP). In the mid-eighties, DKD-ESRD-patients increasingly were accepted for dialysis (1986: 14.53 PMP, 1996: 31.16 PMP). After a peak incidence of 415 diabetic ESRD-patients in 2006 (50.19 PMP), numbers decreased continuously thereafter (2013: 299 patients, 35.73 PMP). Mean age at start of dialysis increased over time and was lower in type 1- and higher in type 2- compared with non-diabetic patients. Five-year-survival-probability in two diabetic ESRD-cohorts, starting in 2007/08 and 10 years earlier was calculated. Five-year-survival was 28% in 1997/98 and 37.5% in 2007/08. Adjusted relative risk reduction was 33% (HR 0.67, CI 95% 0.57-0.78; P < 0.001).
  
  
  CONCLUSIONS
  Despite a growing prevalence of diabetes, the incidence of diabetic ESRD has decreased after 2006. Five-year-survival-probability has improved over 10 years. Multifactorial therapeutic interventions may have resulted in this improvement.
authors.affiliation: Division of Nephrology, 4th Department of Medicine, Klinikum Wels-Grieskirchen, Wels, Austria.
authors.forename: Friedrich C
authors.initials: FC
authors.lastname: Prischl
authors.affiliation: 3rd Department of Internal Medicine, Hospital Hietzing, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Auinger
authors.affiliation: Department for Nephrology and Dialysis, University Clinic for Internal Medicine 3, Medical University of Vienna, Vienna, Austria.
authors.forename: Marcus
authors.initials: M
authors.lastname: Säemann
authors.affiliation: Department of Internal Medicine 4 (Nephrology and Hypertension), Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Mayer
authors.affiliation: Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Rosenkranz
authors.affiliation: Division of Nephrology, 4th Department of Medicine, Klinikum Wels-Grieskirchen, Wels, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Wallner
authors.affiliation: Rohr/Kremstal, Steyr-Land, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kramar
mesh_terms: D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D006435:Renal Dialysis; D013997:Time Factors
keywords: diabetic kidney disease; diabetic nephropathy; end-stage renal disease; incidence; survival probability