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. 2018 Mar;37(1):20-29.
doi: 10.23876/j.krcp.2018.37.1.20. Epub 2018 Mar 31.

Current characteristics of dialysis therapy in Korea: 2016 registry data focusing on diabetic patients

Dong-Chan Jin  1 , Sung-Ro Yun  2 , Seoung Woo Lee  3 , Sang-Woong Han  4 , Won Kim  5 , Jongha Park  6 , Yong-Kyun Kim  1
Affiliations

Current characteristics of dialysis therapy in Korea: 2016 registry data focusing on diabetic patients

Dong-Chan Jin et al. Kidney Res Clin Pract. 2018 Mar.

Abstract

Diabetic nephropathy is the most frequent cause of end-stage renal disease worldwide. Dialysis patients with diabetes mellitus (DM) have more complications and shorter survival duration than non-DM dialysis patients, requiring more clinical attention and difficult management. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an on-line registry program and analyzed the characteristics of patients. A survey of dialysis patients in 2016 showed that 50.2% of new dialysis patients had DM nephropathy as the cause of end-stage renal disease. The proportion of patients receiving hemodialysis (HD) for more than 5 years was 38% in DM patients and 51% in non-DM patients. The mean pulse pressure in DM HD patients was 71.5 mmHg, compared with 62.6 mmHg in non-DM patients. The proportion of DM patients with native vessel arteriovenous fistula as vascular access for HD was lower than that of non-DM patients (73% vs. 78%). Mean serum creatinine of DM and non-DM dialysis patients was 8.4 mg/dL and 9.5 mg/dL respectively. As vascular access of the DM HD patients was poor, the dialysis adequacy of DM patients was slightly lower than that of non-DM patients. The 5-year survival rate for DM HD patients was 53.9%, which was much lower than that of chronic glomerulonephritis patients (78.2%). The proportion of patients with a full-time job was 17% for DM patients and 28% for non-DM patients.

Keywords: Diabetes mellitus; Dialysis adequacy; Korea; Renal dialysis; Renal replacement therapy.

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Conflict of interest statement

Conflicts of interest All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Prevalence and characteristics of dialysis in Korea
(A) Number of patients with renal replacement therapy at the end of each year. (B) Proportion of renal replacement modalities, annual prevalence, and incidence. (C) Changes in the proportion of three major causes of end-stage renal disease. (D) Age distribution of dialysis patients according to underlying diseases. (E) Mean arterial pressure of maintenance hemodialysis (HD) and peritoneal dialysis (PD) patients according to year. (F) Percent distribution of erythropoietin doses of HD and PD patients according to year. CGN, chronic glomerulonephritis; DM, diabetic nephropathy; EPO, erythropoietin; HTN, hypertensive nephrosclerosis; KT, kidney transplantation; MAP, mean arterial pressure.
Figure 2
Figure 2. Dialysis characteristics
(A) Percent of patients receiving hemodiafiltration (HDF) and dialyzer membrane surface area. (B) Vascular access for hemodialysis (HD). (C) Dialysis adequacy parameters (normalized protein catabolic rate [nPCR] and single-pool Kt/V [spKt/ V]) of HD patients. (D) Rehabilitation status of HD and peritoneal dialysis (PD) patients. (E) Patient survival rates according to underlying diseases (registered dialysis patients in Korean Society of Nephrology registry since 2001). (F) Annual number of kidney transplantations (KT) in Korea (including data from Korean Network for Organ Sharing). *Number of surviving patients waiting for KT at the end of each year. AVF, arteriovenous fistula; AVG, arteriovenous graft; Cath, catheter; DM, diabetic nephropathy; GN, chronic glomerulonephritis; HTN, hypertensive nephrosclerosis; Misc, miscellaneous; Temp., temperature.
Figure 3
Figure 3. Characteristics of diabetic dialysis patients
(A) Gender ratio of diabetes mellitus (DM) and non-DM dialysis patients. (B) Dialysis modalities of DM dialysis patients compared with non-DM patients. (C) Proportion of DM hemodialysis (HD) patients according to the dialysis center type (university hospital [Univ Hosp], general hospital [Hosp], private clinic). (D) Duration of dialysis maintenance in DM and non-DM patients for HD vs. peritoneal dialysis (PD). (E) Body mass index (BMI) distribution of DM patients compared with non-DM patients. (F) Comparison of blood pressure (BP) between DM and non-DM dialysis patients.
Figure 4
Figure 4. Characteristics of elderly dialysis patients
(A) Vascular access of diabetes mellitus (DM) hemodialysis (HD) patients compared with non-DM HD patients. (B) Dialyzer surface area of DM and non-DM HD patients. (C) Laboratory data of DM and non-DM dialysis patients. (D) HD adequacy comparison of DM and non-DM patients according to year. (E) Comparison of comorbid conditions in DM and non-DM dialysis patients. (F) Rehabilitation status of DM and non-DM dialysis patients. AVF, arteriovenous fistula; AVG, arteriovenous graft; Cath, catheter; CVA, cerebrovascular accident; Hb, hemoglobin; spKt/V; single-pool Kt/V; Temp., temperature.
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References

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