Diabetes and Renal Disease in Veterans

  1. Bessie A. Young, MD, MPH1234,
  2. Jacqueline A. Pugh, MD56,
  3. Charles Maynard, PHD127 and
  4. Gayle Reiber, PHD, MPH1278
  1. 1Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Washington
  2. 2Health Services Research and Development, Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Washington
  3. 3Department of Medicine, Division of General Internal Medicine, Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Washington
  4. 4Northwest Kidney Centers, Seattle, Washington
  5. 5VERDICT Health Services Research and Development Center of Excellence, Department of Veterans Affairs, South Texas Veterans Health Care System, San Antonio, Texas
  6. 6Department of Medicine, Division of General Internal Medicine, University of Texas Health Science Center, San Antonio, Texas
  7. 7Department of Health Services, University of Washington, Seattle, Washington
  8. 8Department of Epidemiology, University of Washington, Seattle, Washington
  1. Address correspondence and reprint requests to Bessie A. Young, MD, MPH, VA Puget Sound Health Care System (152-E), 1660 S. Columbian Way, Seattle, WA 98108. E-mail: youngb{at}u.washington.edu

Abstract

OBJECTIVE—To describe the frequency and sequelae of diabetic renal disease in veterans who receive health care from the Veterans Administration (VA).

RESEARCH DESIGN AND METHODS—Veterans with a diagnosis of diabetes, diabetic nephropathy, other kidney diseases, and end-stage renal disease (ESRD) were identified by diagnosis codes from national VA databases for FY1998. Data were obtained and analyzed for prevalence of renal disease, comorbid conditions, and 1-year mortality.

RESULTS—A total of 44,671 (10.7%) of the 415,910 veterans with diabetes had a concomitant diagnosis of any renal disease. The average age was 67 years; 98% were male and 60% were white. The prevalence of diabetic nephropathy was 6.0% (n = 25,263). ESRD secondary to diabetes was present in 4.2% (17,636) of subjects. The age-standardized prevalence of diabetes and any renal disease was 72.6/1,000 persons and differed by race (white 76.1/1,000, black 103.4/1,000 persons). Diabetes-associated ESRD prevalence was higher among black versus white veterans and male versus female veterans. One-year age-standardized mortality was 10.7%.

CONCLUSIONS—Nephropathy is prevalent in veterans with diabetes. Greater mortality is observed among those with renal disease compared with those without renal disease. Additional surveillance is needed to identify persons likely to progress to diabetic nephropathy and to plan for appropriate and timely health care for these individuals.

Footnotes

  • Funding for this supplement was provided by The Seattle Epidemiologic Research and Information Center and the VA Cooperative Studies Program.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted July 25, 2003.
    • Received July 1, 2003.
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  1. doi: 10.2337/diacare.27.suppl_2.B45 Diabetes Care May 2004 vol. 27 no. suppl 2 b45-b49
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