Diabetes-related kidney disease deadly: study

NEW YORK (Reuters Health) - Results of a study confirm that the outlook is poor for type 1 diabetic patients who develop end-stage renal disease (ESRD) -- the most advanced form of kidney disease.

"End stage renal disease remains a dreadful complication in patients with type 1 diabetes, and great effort to prevent kidney disease in these young patients is needed," write researchers in the medical journal Diabetes Care.

In ESRD, the kidneys lose their ability to filter waste products from the blood and excrete them in the urine. People with ESRD need kidney dialysis or a kidney transplant to stay alive. Diabetes is the most important cause of ESRD.

Researchers examined the epidemiology and long-term survival of patients with ESRD by diabetic status in Australia and New Zealand (ANZ). Dr. Emmanuel Villar, of the ANZDATA Registry in Woodville, South Australia, and colleagues included in their study all patients at least 16 years of age who started renal replacement therapy from April 1, 1991 to December 31, 2005.

Analyses centered on 1,284 type 1 diabetic patients, 8,560 type 2 diabetic patients, and 18,704 non-diabetic patients.

Compared with non-diabetic patients, the risk of death after the first renal replacement therapy was 64 percent higher in those with type 1 diabetes and 13 percent higher in those with type 2 diabetes, Villar and colleagues found.

There was no change in survival per 5-year period in type 1 diabetic patients, but significant improvements were observed in type 2 diabetic patients and in non-diabetic patients.

Summing up, the researchers note that "despite high access to renal transplants, type 1 diabetic patients had a poor prognosis after starting renal replacement therapy."

Risk factors for kidney disease in patients with type 1 diabetes include high blood pressure and high lipid levels, as well as longer disease duration, elevated blood sugar levels, and male gender.

SOURCE: Diabetes Care, December 2007.