Incidence of treatment for end-stage renal disease among individuals with diabetes in the U.S. continues to decline.
Incidence of treatment for end-stage renal disease among individuals with diabetes in the U.S. continues to decline.
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DOI：
10.2337/dc09-0343
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发表时间：
2010-01
期刊：
影响因子：
16.2
通讯作者：
Geiss LS
中科院分区：
文献类型：
--
作者：
Burrows NR;Li Y;Geiss LS
我们研究了美国糖尿病相关终末期肾病（ESRD）治疗发生率的趋势。使用美国肾脏数据系统，我们获得了1990年至2006年期间开始ESRD治疗的糖尿病患者人数。发病率的计算使用了美国国家健康访谈调查中估计的美国糖尿病人群，然后根据2000年美国标准人群进行了年龄调整。使用联合点回归分析趋势。开始糖尿病相关ESRD治疗的人数从1990年的17，727人增加到2006年的48，215人。从1990年到1996年，年龄调整的糖尿病相关ESRD发病率从299.0/10万糖尿病人群增加到343.2/10万糖尿病人群（P = 0.45）。然而，从1996年到2006年，年龄调整的糖尿病相关ESRD发病率每年下降3.9%（P < 0.01），从每10万糖尿病人群343.2例下降到197.7例。在45岁以下的糖尿病患者中，糖尿病相关的ESRD发病率从1990年到2006年每年下降4.3%（P < 0.01）。在老年人中，发病率在20世纪90年代增加，但在以后几年下降，45-64岁的人每年下降3.9%（P <0.01），65-74岁的人每年下降3.4%（P < 0.01），≥75岁的人每年下降2.1%（P = 0.02）。糖尿病人群中糖尿病相关ESRD的发病率在所有年龄组均有所下降，可能是因为ESRD风险因素的患病率降低、治疗和护理改善以及其他因素。
We examined trends in incidence of treatment for diabetes-related end-stage renal disease (ESRD) in the U.S. Using the U.S. Renal Data System, we obtained the number of individuals having diabetes listed as primary diagnosis who initiated ESRD treatment between 1990 and 2006. Incidence was calculated using the estimated U.S. population with diabetes from the National Health Interview Survey and then was age adjusted based on the 2000 U.S. standard population. Trends were analyzed using joinpoint regression. The number of individuals who began diabetes-related ESRD treatment increased from 17,727 in 1990 to 48,215 in 2006. From 1990 to 1996, the age-adjusted diabetes-related ESRD incidence increased somewhat from 299.0 to 343.2 per 100,000 diabetic population (P = 0.45). However, from 1996 to 2006, the age-adjusted diabetes-related ESRD incidence decreased by 3.9% per year (P < 0.01) from 343.2 to 197.7 per 100,000 diabetic population. Among individuals with diabetes aged <45 years, diabetes-related ESRD incidence decreased by 4.3% per year (P < 0.01) from 1990 to 2006. Among older individuals, incidence increased during the 1990s but decreased in later years, by 3.9% per year (P < 0.01) among individuals aged 45–64, by 3.4% per year (P < 0.01) among individuals aged 65–74 years, and by 2.1% per year (P = 0.02) among individuals aged ≥75 years. Diabetes-related ESRD incidence in the diabetic population has declined in all age-groups, probably because of a reduction in the prevalence of ESRD risk factors, improved treatment and care, and other factors.