Rates and outcomes of diabetic end-stage renal disease among registered native people in Saskatchewan

Abstract

Objective: To determine the rates and outcomes of diabetic end-stage renal disease (ESRD) among registered native people and non-native people in Saskatchewan.

Design: Retrospective population-based study using data from the Canadian Organ Replacement Registry.

Setting: Saskatchewan.

Patients: All patients with diabetic ESRD diagnosed between Jan. 1, 1981, and Dec. 31, 1990.

Main outcome measures: Incidence rates of diabetic ESRD in the general population, rates of diabetic ESRD among patients with diabetes mellitus, nature of initial dialysis treatment, length of survival from start of dialysis, cause of death and renal transplant rates.

Results: The 10-year incidence rates of diabetic ESRD were higher among all age groups among registered native people than among non-native people. The overall relative risk ratio for native people was 16.2. When a higher prevalence of diabetes among native people was taken into account, native diabetic people were still seven times as likely as non-native diabetic people to manifest diabetic ESRD. The median survival from start of dialysis was under 2 years in both groups, but more native people died of stroke and more non-native people died of heart disease. Non-native diabetic people were more likely than native diabetic people to receive renal transplants.

Conclusions: Although the overall incidence of diabetic ESRD in Saskatchewan is increasing, registered native people have a disproportionate risk for this serious complication.