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. 2010 Aug;33(8):1718-23.
doi: 10.2337/dc10-0030. Epub 2010 Apr 30.

Survival of patients with type 1 diabetes receiving renal replacement therapy in 1980-2007

Mikko Haapio  1 , Jaakko Helve, Per-Henrik Groop, Carola Grönhagen-Riska, Patrik Finne
Affiliations

Survival of patients with type 1 diabetes receiving renal replacement therapy in 1980-2007

Mikko Haapio et al. Diabetes Care. 2010 Aug.

Abstract

Objective: Risks of end-stage renal disease and premature death in patients with type 1 diabetes have declined over the past decades. Data on the survival of patients receiving renal replacement therapy (RRT) are, however, limited. We investigated whether survival of patients with type 1 diabetes receiving RRT has improved over time and whether improvement can be attributable to progress in dialysis treatment or diabetes care.

Research design and methods: An incident cohort of all patients with type 1 diabetes (n = 1,604) starting chronic RRT in Finland between 1980 and 2005 were followed until death or end of follow-up on 31 December 2007. The control group (n = 1,556) consisted of patients with glomerulonephritis who started RRT. All patients were identified from the Finnish Registry for Kidney Diseases.

Results: Median survival time of patients with type 1 diabetes increased progressively from 3.60 years during 1980-1984 to >8 years in 2000-2005. In 2000-2005, the unadjusted relative risk of death was 0.55 compared with 1980-1984. After adjustment for the most important variables, the corresponding relative risk of death was only 0.23. For patients with glomerulonephritis, the adjusted relative risk decreased to a lesser extent to 0.30 (P = 0.007).

Conclusions: Survival of patients with type 1 diabetes and end-stage renal disease has improved since the 1980s despite a conspicuous increase in the age of patients who start RRT, suggesting not only true progress in dialysis therapy and overall treatment of patients with end-stage renal disease but possibly also improved management of diabetes.

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Figures

Figure 1
Figure 1
Survival probability of type 1 diabetic patients beginning RRT according to start period of RRT. Dashed lines denote cut points for median survival times.
Figure 2
Figure 2
Survival probability of patients with type 1 diabetes beginning RRT according to start period of RRT and age at start of RRT. Survival probabilities were statistically significantly different between start year periods in all age-groups (P < 0.005).
See this image and copyright information in PMC

References

    1. U.S. Renal Data System USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States Bethesda, MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2007
    1. Lammi N, Blomstedt PA, Moltchanova E, Eriksson JG, Tuomilehto J, Karvonen M. Marked temporal increase in the incidence of type 1 and type 2 diabetes among young adults in Finland. Diabetologia 2008;51:897–899 - PubMed
    1. Harjutsalo V, Sjöberg L, Tuomilehto J. Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study. Lancet 2008;371:1777–1782 - PubMed
    1. Finnish Registry for Kidney Diseases Report 2007 [article online], 2008. Available from http://www.musili.fi/smtr/english Accessed 16 June 2010
    1. Finne P, Reunanen A, Stenman S, Groop PH, Grönhagen-Riska C. Incidence of end-stage renal disease in patients with type 1 diabetes. JAMA 2005;294:1782–1787 - PubMed

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