End-stage renal disease (ESRD) can be considered a health epidemic involving considerable human and financial resources. The number of patients with ESRD is increasing in the world due to aging populations, longer life expectancy, increasing access to renal replacement therapies (RRT), and higher incidence of diabetes mellitus (DM) and hypertension. Nowadays, dialysis is the dominating therapy to prevent death from uremia, in large part because donor kidneys are in short supply, and thus, the survival of these patients is still a major concern. According to the United States Renal Data System (USRDS), in 2008, the adjusted rate of prevalent ESRD cases rose 1.9%, to 1.699 per million population (pmp), with 547.982 patients under treatment.
The prevalent dialysis population increased 3.6%, reaching 382.343 patients and has grown 34.7% since 2000. Among these amazing numbers, DM is present as the leading cause of ESRD in the USA and most other countries. After a dramatic increase in the incidence rate of ESRD due to diabetes, peaking in 2006 at 160 pmp, this rate fell 3.2% and 1.5% in the following two years, reaching 153 pmp in 2008, but still corresponding to 43% of all incident patients.
Although their survival is still much worse than that of nondiabetic counterparts, mainly because of the preexisting severely compromised cardiovascular conditions, between 1994–1998 and 1999–2003, the 5-year diabetic patients survival improved 15.3% in hemodialysis (HD) and 27.1% in peritoneal dialysis (PD), reaching 29% and 27%, respectively. In Europe, diabetes as the cause of ESRD averaged 124 pmp. In the cohort 1999–2003, the unadjusted 1-, 2- and 5-year survival of patients on RRT was 80.8% (95% CI: 80.6–81.0), 69.1% (95% CI: 68.9–69.3), and 46.1% (95% CI: 45.9–46.3), respectively. Survival of incident diabetic patients either in HD and PD was the lowest and around 30% by 5 years.
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The prevalent dialysis population increased 3.6%, reaching 382.343 patients and has grown 34.7% since 2000. Among these amazing numbers, DM is present as the leading cause of ESRD in the USA and most other countries. After a dramatic increase in the incidence rate of ESRD due to diabetes, peaking in 2006 at 160 pmp, this rate fell 3.2% and 1.5% in the following two years, reaching 153 pmp in 2008, but still corresponding to 43% of all incident patients.
Although their survival is still much worse than that of nondiabetic counterparts, mainly because of the preexisting severely compromised cardiovascular conditions, between 1994–1998 and 1999–2003, the 5-year diabetic patients survival improved 15.3% in hemodialysis (HD) and 27.1% in peritoneal dialysis (PD), reaching 29% and 27%, respectively. In Europe, diabetes as the cause of ESRD averaged 124 pmp. In the cohort 1999–2003, the unadjusted 1-, 2- and 5-year survival of patients on RRT was 80.8% (95% CI: 80.6–81.0), 69.1% (95% CI: 68.9–69.3), and 46.1% (95% CI: 45.9–46.3), respectively. Survival of incident diabetic patients either in HD and PD was the lowest and around 30% by 5 years.
kidneyhospitalabroad@hotmail.com
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