Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 147 No. 2728 (2017)

Changing trends in end-stage renal disease patients with diabetes

DOI
https://doi.org/10.4414/smw.2017.14458
Cite this as:
Swiss Med Wkly. 2017;147:w14458
Published
06.07.2017

Summary

BACKGROUND

Worldwide, diabetes has become the most common cause of end-stage renal disease (ESRD), yet Swiss data are largely lacking.

METHODS

This observational study examined ESRD patients with diabetes mellitus (ESRD-DM) at end of 2009 and 2014. The prevalence and characteristics of ESRD-DM patients were collected in all dialysis facilities in the Canton of Vaud of Switzerland in 2009 and in 2014, and the 5-year mortality rate was assessed.

RESULTS

A total of 107 and 140 ESRD-DM patients underwent dialysis at end of 2009 and 2014, respectively. Within the 5-year period a total of 167 incidental ESRD-DM patients required dialysis, corresponding to an estimated incidental rate of 0.84/1000 person-years in the diabetic population. In 2009, all patients with ESRD-DM underwent haemodialysis, decreasing to 96.2% in 2014, with 3.8% on peritoneal dialysis. Age, sex, body mass index, type of diabetes, duration of diabetes, cause of ESRD, dialysis duration, dialysis frequency, vascular access, and glycosylated haemoglobin levels did not differ between 2009 and 2014. In 2014, macrovascular comorbidity was reported more often than in 2009, but not amputations. Haemoglobin level decreased significantly from 117.9 g/l to 112.3 g/l. Calcium-containing phosphate binder and angiotensin-converting enzyme inhibitor use significantly decreased, whereas iron therapy significantly increased with time. The 5-year mortality rate was 61.7%. Five-year survivors were significantly younger and had a higher body mass index.

CONCLUSIONS

The growing prevalence of ESRD-DM emphasises that prevention of chronic kidney disease and its progression should be a public health priority in Switzerland.

References

  1. Levey AS, Atkins R, Coresh J, Cohen EP, Collins AJ, Eckardt KU, et al. Chronic kidney disease as a global public health problem: approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes. Kidney Int. 2007;72(3):247–59. https://doi.org/10.1038/sj.ki.5002343
  2. Meguid El Nahas A, Bello AK. Chronic kidney disease: the global challenge. Lancet. 2005;365(9456):331–40. https://doi.org/10.1016/S0140-6736(05)17789-7
  3. Snyder JJ, Collins AJ. KDOQI hypertension, dyslipidemia, and diabetes care guidelines and current care patterns in the United States CKD population: National Health and Nutrition Examination Survey 1999-2004. Am J Nephrol. 2009;30(1):44–54. https://doi.org/10.1159/000201014
  4. United States Renal Data System. 2015 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD. 2015.
  5. Foley RN, Collins AJ. End-stage renal disease in the United States: an update from the United States Renal Data System. J Am Soc Nephrol. 2007;18(10):2644–8. https://doi.org/10.1681/ASN.2007020220
  6. Hill CJ, Fogarty DG. Changing trends in end-stage renal disease due to diabetes in the United kingdom. J Ren Care. 2012;38(Suppl 1):12–22. https://doi.org/10.1111/j.1755-6686.2012.00273.x
  7. Huang YY, Lin KD, Jiang YD, Chang CH, Chung CH, Chuang LM, et al. Diabetes-related kidney, eye, and foot disease in Taiwan: an analysis of the nationwide data for 2000-2009. J Formos Med Assoc. 2012;111(11):637–44. https://doi.org/10.1016/j.jfma.2012.09.006
  8. Hanafusa N, Nakai S, Iseki K, Tsubakihara Y. Japanese society for dialysis therapy renal data registry-a window through which we can view the details of Japanese dialysis population. Kidney Int Suppl (2011). 2015;5(1):15–22. https://doi.org/10.1038/kisup.2015.5
  9. Annual Report of the Dialysis Outcomes and Practice Patterns Study: Hemodialysis Data 1997-2011. Ann Arbor, MI: Arbor Research Collaborative for Health; 2012.
  10. Lassalle M, Ayav C, Frimat L, Jacquelinet C, Couchoud C ; Au Nom du Registre REIN. The essential of 2012 results from the French Renal Epidemiology and Information Network (REIN) ESRD registry. Nephrol Ther. 2015;11(2):78–87. https://doi.org/10.1016/j.nephro.2014.08.002
  11. Sørensen VR, Hansen PM, Heaf J, Feldt-Rasmussen B. Stabilized incidence of diabetic patients referred for renal replacement therapy in Denmark. Kidney Int. 2006;70(1):187–91. https://doi.org/10.1038/sj.ki.5001516
  12. Grace BS, Clayton P, McDonald SP. Increases in renal replacement therapy in Australia and New Zealand: understanding trends in diabetic nephropathy. Nephrology (Carlton). 2012;17(1):76–84. https://doi.org/10.1111/j.1440-1797.2011.01512.x
  13. American Diabetes Association. Standards of medical care in diabetes--2008. Diabetes Care. 2008;31(Suppl 1):S12–54. https://doi.org/10.2337/dc08-S012
  14. International Diabetes Federation. Diabetes in Switzerland - 2015 [Internet]. 2015 Dec [cited 2016 Mar 15] Available from: http://www.idf.org/membership/eur/Switzerland.
  15. Saudan P, Kossovsky M, Halabi G, Martin PY, Perneger TV ; Western Switzerland Dialysis Study Group. Quality of care and survival of haemodialysed patients in western Switzerland. Nephrol Dial Transplant. 2008;23(6):1975–81. Published online December 25, 2007. https://doi.org/10.1093/ndt/gfm915
  16. Breidthardt T, Moser-Bucher CN, Praehauser C, Garzoni D, Bächler K, Steiger J, et al. Morbidity and mortality on chronic haemodialysis: a 10-year Swiss single centre analysis. Swiss Med Wkly. 2011;141:w13150. Published online February 18, 2011. doi:.https://doi.org/10.4414/smw.2011.13150
  17. Lehmann PR, Ambühl M, Corleto D, Klaghofer R, Ambühl PM. Epidemiologic trends in chronic renal replacement therapy over forty years: a Swiss dialysis experience. BMC Nephrol. 2012;13(1):52. Published online July 04, 2012. https://doi.org/10.1186/1471-2369-13-52
  18. Golshayan D, Paccaud F, Wauters JP. [Epidemiology of end-stage renal failure: comparison between 2 Swiss cantons]. Nephrologie. 2002;23(4):179–84. Article in French.
  19. Registry ERA-EDTA. ERA-EDTA Registry Annual Report 2014. Academic Medical Center, Department of Medical Informatics, Amsterdam, the Netherlands, 2016.
  20. Wauters JP, Uehlinger D. Non-medical factors influencing peritoneal dialysis utilization: the Swiss experience. Nephrol Dial Transplant. 2004;19(6):1363–7. https://doi.org/10.1093/ndt/gfh090
  21. Biller-Andorno N, Zeltner T. Individual Responsibility and Community Solidarity--The Swiss Health Care System. N Engl J Med. 2015;373(23):2193–7. https://doi.org/10.1056/NEJMp1508256
  22. Pfeffer MA, Burdmann EA, Chen CY, Cooper ME, de Zeeuw D, Eckardt KU, et al.; TREAT Investigators. A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease. N Engl J Med. 2009;361(21):2019–32. https://doi.org/10.1056/NEJMoa0907845
  23. Drüeke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al.; CREATE Investigators. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006;355(20):2071–84. https://doi.org/10.1056/NEJMoa062276
  24. Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, et al.; CHOIR Investigators. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006;355(20):2085–98. https://doi.org/10.1056/NEJMoa065485
  25. Palmer SC, Navaneethan SD, Craig JC, Johnson DW, Tonelli M, Garg AX, et al. Meta-analysis: erythropoiesis-stimulating agents in patients with chronic kidney disease. Ann Intern Med. 2010;153(1):23–33. https://doi.org/10.7326/0003-4819-153-1-201007060-00252
  26. Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int. 2012;2 (suppl).
  27. Hill KM, Martin BR, Wastney ME, McCabe GP, Moe SM, Weaver CM, et al. Oral calcium carbonate affects calcium but not phosphorus balance in stage 3-4 chronic kidney disease. Kidney Int. 2013;83(5):959–66. https://doi.org/10.1038/ki.2012.403
  28. Spiegel DM, Brady K. Calcium balance in normal individuals and in patients with chronic kidney disease on low- and high-calcium diets. Kidney Int. 2012;81(11):1116–22. https://doi.org/10.1038/ki.2011.490
  29. Mafra D, Guebre-Egziabher F, Fouque D. Body mass index, muscle and fat in chronic kidney disease: questions about survival. Nephrol Dial Transplant. 2008;23(8):2461–6. Published online April 09, 2008. https://doi.org/10.1093/ndt/gfn053
  30. Kovesdy CP, Park JC, Kalantar-Zadeh K. Glycemic control and burnt-out diabetes in ESRD. Semin Dial. 2010;23(2):148–56. Published online April 09, 2010. https://doi.org/10.1111/j.1525-139X.2010.00701.x
  31. Eckardt KU, Gillespie IA, Kronenberg F, Richards S, Stenvinkel P, Anker SD, et al.; ARO Steering Committee. High cardiovascular event rates occur within the first weeks of starting hemodialysis. Kidney Int. 2015;88(5):1117–25. https://doi.org/10.1038/ki.2015.117