Survival of patients with type 1 diabetes on renal replacement therapy in 1980-2007

  1. Patrik Finne, MD, PHD3,4
  1. 1Helsinki University Central Hospital, Division of Nephrology, Helsinki, Finland
  2. 2Helsinki University Central Hospital, Department of Medicine, Helsinki, Finland
  3. 3Finnish Registry for Kidney Diseases, Helsinki, Finland
  4. 4School of Public Health, University of Tampere, Tampere, Finland

Abstract

Objective - Risks of end-stage renal disease and premature death in patients with type 1 diabetes have declined over the past decades. Data on their survival on renal replacement therapy (RRT) are, however, limited. We investigated whether survival of patients with type 1 diabetes on RRT has improved over time and, if improvement can be attributable to progress in dialysis treatment or diabetes care.

Research design and methods - An incident cohort of all patients with type 1 diabetes (n = 1604) entering chronic RRT in Finland between 1980 and 2005 were followed until death or end of follow-up on 31 December 2007. Control group (n = 1556) consisted of glomerulonephritis patients that entered RRT. All patients were identified from the Finnish Registry for Kidney Diseases.

Results - Median survival time of patients with type 1 diabetes increased progressively from 3.60 years during 1980-1984 to more than 8 years in 2000-2005. In 2000-2005 the unadjusted relative risk of death was 0.55 compared to 1980-1984. After adjustment for most important variables the corresponding relative risk of death was only 0.23. For glomerulonephritis patients the adjusted relative risk decreased to a lesser extent to 0.30 (P = 0.007).

Conclusions - Survival of patients with type 1 diabetes and end-stage renal disease has improved since the 1980s despite a conspicuous increase in age of patients that enter RRT, suggesting true progress not only in dialysis therapy and overall treatment of patients with end-stage renal disease, but possibly also improved management of diabetes.

Footnotes

  • Received January 7, 2010.
  • Accepted April 21, 2010.

This Article

  1. Diabetes Care
  1. All Versions of this Article:
    1. dc10-0030v1
    2. 33/8/1718 most recent