Ten-year comparative analysis of incidence, prognosis, and associated factors for dialysis and renal transplantation in type 1 and type 2 diabetes versus non-diabetes
| Autor: | Giuseppe Costa, Roberto Gnavi, Mario Salomone, Carlo Giorda, Barbara Tartaglino, Paolo Carnà, Roberta Picariello |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
dialysis incidence mortality Endocrinology Diabetes and Metabolism medicine.medical_treatment 030232 urology & nephrology Type 2 diabetes 0302 clinical medicine Endocrinology Risk Factors Diabetic Nephropathies Child Aged 80 and over education.field_of_study Incidence Mortality rate Incidence (epidemiology) General Medicine Middle Aged Prognosis Italy Child Preschool symbols Female Adult medicine.medical_specialty Adolescent Population 030209 endocrinology & metabolism Young Adult 03 medical and health sciences symbols.namesake Renal Dialysis Internal medicine Diabetes mellitus Internal Medicine medicine Humans Poisson regression education Dialysis Aged business.industry Infant Newborn Infant medicine.disease Kidney Transplantation Transplantation Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Case-Control Studies business Follow-Up Studies |
| Popis: | To study the incidence of and the factors associated with renal dialysis and transplantation in type 1 (T1DM) and type 2 diabetes (T2DM). Data on individuals who had received dialysis treatment or renal transplant between 1 January 2004 and 31 December 2013 were extracted from the regional administrative database (Piedmont, Italy), and the crude (cumulative) incidence of dialysis was calculated. Overall cumulative survival was estimated using the Kaplan–Meier method and compared using the log-rank test. Poisson regression was used to estimate adjusted rate ratios for potential predictors of renal transplant or death. A total of 7401 persons started dialysis treatment during the decade, with a 10-year cumulative crude incidence of 16.8/100,000. Incidence was stable and consistently eightfold higher in persons with T2DM (tenfold higher in T1DM) compared to those without diabetes. The risk of dialysis in T1DM was about double that of T2DM. The mortality rate was significantly higher in diabetics than in non-diabetes (241.4/1000 vs. 153.99/1000 person-years). During the decade 2004–2013, 893 patients underwent a kidney transplant. Transplantation rates were significantly lower for diabetics than non-diabetics (16.5/1000 vs. 42.9/1000 person-years). In the past decade, the incidence of dialysis has stabilized in both the general population and in diabetics in whom it remains far higher by comparison. Also mortality rates are higher, with a worse prognosis for T1DM. Diabetes poses a barrier to allotransplantation, and efforts should be made to overcome this limitation. |
| Databáze: | OpenAIRE |
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