Causes of death in diabetic patients with impaired renal function. An audit of a hospital diabetic clinic population.

Of over 2000 diabetic patients whose serum creatinine had been measured regularly, 107 died between January, 1983, and March, 1985, and 27 (median age at death 66 years) had renal impairment (serum creatinine over 130 mumol/l). Cause of death was determined from clinical and necropsy data. 11 died of cardiovascular disease and 10 of causes unrelated to cardiac or renal disease; in only 6 was renal impairment the main cause of death. All 6 had severe physical and/or social disabilities and 2 were over the age of 75. Median serum creatinine in patients who died was 269 mumol/l (range 135-1135 mumol/l) and exceeded 500 mumol/l in only 5. Of the few patients who would have received RRT under a more liberal dialysis policy, all had severe physical disabilities.