Incidence of renal replacement therapy (RRT) in the diabetic compared with the non-diabetic population in a German region, 2002-08

Icks, Andrea; Haastert, Burkhard; Genz, Jutta; Giani, Guido; Hoffmann, Falk; Trapp, Rudolf; Koch, Michael

doi:10.1093/ndt/gfq398

Cited by 24 publications

(25 citation statements)

References 21 publications

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“…Male sex increases the incidence, prevalence and progression of chronic kidney disease [9]. Thus, most of the patients that need renal replacement therapy are men [10]. Although these phenomena have always been attributed to the protective effects of estrogens, recently it has been suggested that male hormones may play a critical role in these differences [11].…”

Section: Introductionmentioning

confidence: 99%

Gonadectomy prevents the increase in blood pressure and glomerular injury in angiotensin-converting enzyme 2 knockout diabetic male mice. Effects on renin–angiotensin system

Clotet¹,

Soler

Rebull³

et al. 2016

Journal of Hypertension

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Section: Introductionmentioning

confidence: 99%

Gonadectomy prevents the increase in blood pressure and glomerular injury in angiotensin-converting enzyme 2 knockout diabetic male mice. Effects on renin–angiotensin system

Clotet¹,

Soler

Rebull³

et al. 2016

Journal of Hypertension

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“…DM2 interacts with other major risk factors such as hypertension and dyslipidemia, increasing the risk for micro- and macrovascular morbidity such as chronic kidney disease (CKD), end-stage renal disease (ESRD), atherosclerosis, coronary heart disease and cerebral ischemia [2-5]. For example, diabetic nephropathy is the underlying kidney disease of about every third patient starting renal replacement therapy [6-11]. …”

Section: Introductionmentioning

confidence: 99%

Study design of DIACORE (DIAbetes COhoRtE) – a cohort study of patients with diabetes mellitus type 2

et al. 2013

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BackgroundDiabetes mellitus type 2 (DM2) is highly associated with increased risk for chronic kidney disease (CKD), end stage renal disease (ESRD) and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE).MethodsDIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro- and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e.g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness.DiscussionDIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies.

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“…Previous studies have tended to report incidence of RRT in diabetes as opposed to prevalence. 12 , 13 A large European study comprising of 10 registries showed a small increase in the incidence of RRT for T1DM and a marked increase in the incidence of RRT in T2DM between 1991 to 2000(4). UK registry data showed 15.2% of prevalent patients had diabetes as their PRD and 25% of new incident patients.…”

Section: Resultsmentioning

confidence: 99%

End-stage renal disease and survival in people with diabetes: a national database linkage study

Bell

Fletcher

Brady

et al. 2014

QJM

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Background: Increasing prevalence of diabetes worldwide is projected to lead to an increase in patients with end-stage renal disease (ESRD) requiring renal replacement therapy (RRT).Aim: To provide contemporary estimates of the prevalence of ESRD and requirement for RRT among people with diabetes in a nationwide study and to report associated survival.Methods: Data were extracted and linked from three national databases: Scottish Renal Registry, Scottish Care Initiative-Diabetes Collaboration and National Records of Scotland death data. Survival analyses were modelled with Cox regression.Results: Point prevalence of chronic kidney disease (CKD)5 in 2008 was 1.63% of 19 414 people with type 1 diabetes (T1DM) compared with 0.58% of 167 871 people with type 2 diabetes (T2DM) (odds ratio for DM type 0.97, P = 0.77, on adjustment for duration. Although 83% of those with T1DM and CKD5 and 61% of those with T2DM and CKD5 were receiving RRT, there was no difference when adjusted for age, sex and DM duration (odds ratio for DM type 0.83, P = 0.432). Diabetic nephropathy was the primary renal diagnosis in 91% of people with T1DM and 58% of people with T2DM on RRT. Median survival time from initiation of RRT was 3.84 years (95% CI 2.77, 4.62) in T1DM and 2.16 years (95% CI: 1.92, 2.38) in T2DM.Conclusion: Considerable numbers of patients with diabetes continue to progress to CKD5 and RRT. Almost half of all RRT cases in T2DM are considered to be due to conditions other than diabetic nephropathy. Median survival time for people with diabetes from initiation of RRT remains poor. These prevalence data are important for future resource planning.

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Incidence of renal replacement therapy (RRT) in the diabetic compared with the non-diabetic population in a German region, 2002-08

Cited by 24 publications

References 21 publications

Gonadectomy prevents the increase in blood pressure and glomerular injury in angiotensin-converting enzyme 2 knockout diabetic male mice. Effects on renin–angiotensin system

Gonadectomy prevents the increase in blood pressure and glomerular injury in angiotensin-converting enzyme 2 knockout diabetic male mice. Effects on renin–angiotensin system

Study design of DIACORE (DIAbetes COhoRtE) – a cohort study of patients with diabetes mellitus type 2

End-stage renal disease and survival in people with diabetes: a national database linkage study

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