End-stage renal disease (ESRD) is affecting a growing proportion of type 2 diabetics in Australia and New Zealand, a study found.
The study included 28,548 resident adults of the two countries who began renal replacement therapy (RRT) from April 1, 1991 to December 31, 2005. The study population consisted of 8,560 patients with type 2 diabetes, 1,284 with type 1 diabetes, and 18,704 non-diabetics.
Over the study period, the incidence of ESRD in type 2 diabetics increased by 10.2% annually, the investigators reported in Diabetes Care (2007; published online ahead of print). The incidence of ESRD in type 1 diabetics remained stable over the study period; the incidence of nondiabetic ESRD rose by 1.5% annually.
In patients younger than 70 years, rates of renal transplantation in patients with type 1, type 2, and no diabetes were 41.8%, 6.5%, and 40.9%, respectively. Compared with nondiabetics, patients with type 1 and type 2 diabetes were at 64% and 13% higher risk of death after adjusting for potential confounders.
In addition, survival rates per five-year periods improved nonsignificantly by 6% among type 1 diabetics and significantly by 9% and 5% in type 2 diabetics and nondiabetics, respectively.