Friedrich C Prischl1, Martin Auinger2, Marcus Säemann3, Gert Mayer4, Alexander R Rosenkranz5, Manfred Wallner1, Reinhard Kramar6. 1. Division of Nephrology, 4th Department of Medicine, Klinikum Wels-Grieskirchen, Wels, Austria. 2. 3rd Department of Internal Medicine, Hospital Hietzing, Vienna, Austria. 3. Department for Nephrology and Dialysis, University Clinic for Internal Medicine 3, Medical University of Vienna, Vienna, Austria. 4. Department of Internal Medicine 4 (Nephrology and Hypertension), Medical University of Innsbruck, Innsbruck, Austria. 5. Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 6. Rohr/Kremstal, Steyr-Land, Austria.
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). CONCLUSION: 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.
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-diabeticpatients. 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). CONCLUSION: 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: Harald Sourij; Roland Edlinger; Friedrich Prischl; Martin Auinger; Alexandra Kautzky-Willer; Marcus D Säemann; Rudolf Prager; Martin Clodi; Guntram Schernthaner; Gert Mayer; Rainer Oberbauer; Alexander R Rosenkranz Journal: Wien Klin Wochenschr Date: 2016-04 Impact factor: 1.704
Authors: Bradley S Miller; Shoshana R Blumenthal; Alexey Shalygin; Kevin D Wright; Alexander Staruschenko; John D Imig; Andrey Sorokin Journal: Diabetes Date: 2018-08-21 Impact factor: 9.461
Authors: Maria Narres; Heiner Claessen; Tatjana Kvitkina; Michael Koch; Lars Christian Rump; Thomas Weinreich; Andrea Icks Journal: Diabetologia Date: 2019-12-21 Impact factor: 10.122
Authors: Heiner Claessen; Maria Narres; Tatjana Kvitkina; Adrian Wilk; Heiko Friedel; Christian Günster; Falk Hoffmann; Michael Koch; Karin Jandeleit-Dahm; Andrea Icks Journal: Diabetes Care Date: 2021-05-04 Impact factor: 17.152
Authors: Bernhard Bielesz; Janina M Patsch; Lukas Fischer; Marija Bojic; Wolfgang Winnicki; Michael Weber; Daniel Cejka Journal: PLoS One Date: 2017-02-15 Impact factor: 3.240