TY - JOUR
T1 - End-stage renal disease attributable to diabetes mellitus
AU - Perneger, Thomas V.
AU - Brancati, Frederick L.
AU - Whelton, Paul K.
AU - Klag, Michael J.
PY - 1994/12/15
Y1 - 1994/12/15
N2 - Objective: To determine the proportion of end-stage renal disease associated with diabetes mellitus in a biracial population, using population- attributable risk estimates. Design: Case-control study. Setting: Population- based study in Maryland, Virginia, West Virginia, and Washington, D.C. Participants: 716 newly treated patients with kidney failure aged 20 to 64 years and 361 age-matched controls. Measurements: Self-reported history of diabetes mellitus, including type, duration, treatment, and complications. Results: Persons with insulin-dependent diabetes (odds ratio, 33.7) and non- insulin-dependent diabetes (odds ratio, 7.0) were at greater risk for end- stage renal disease than were persons without diabetes. The odds ratio was only slightly increased for diabetes lasting less than 15 years, but the ratio increased more than 20-fold for diabetes lasting 15 years or more. The population-attributable risk for kidney failure was 21% for insulin-dependent diabetes and 21% for non-insulin-dependent diabetes (42% overall). A similar proportion of end-stage renal disease was attributed to diabetes in whites (44%) and in blacks (41%). Insulin-dependent diabetes had a relatively greater effect on the incidence of kidney failure in whites; in contrast, non-insulin-dependent diabetes had a relatively greater effect on kidney failure in blacks. Conclusions: Diabetes mellitus has a major effect on the incidence of end-stage renal disease in nonelderly adults. In black persons, diabetes may be responsible for a larger proportion of end-stage renal disease than is suggested by the use of clinical diagnoses of underlying renal disease made by patients' nephrologists. Prevention of end-stage renal disease associated with diabetes mellitus (both insulin-dependent and non- insulin-dependent diabetes) requires increased attention from laboratory and clinical researchers.
AB - Objective: To determine the proportion of end-stage renal disease associated with diabetes mellitus in a biracial population, using population- attributable risk estimates. Design: Case-control study. Setting: Population- based study in Maryland, Virginia, West Virginia, and Washington, D.C. Participants: 716 newly treated patients with kidney failure aged 20 to 64 years and 361 age-matched controls. Measurements: Self-reported history of diabetes mellitus, including type, duration, treatment, and complications. Results: Persons with insulin-dependent diabetes (odds ratio, 33.7) and non- insulin-dependent diabetes (odds ratio, 7.0) were at greater risk for end- stage renal disease than were persons without diabetes. The odds ratio was only slightly increased for diabetes lasting less than 15 years, but the ratio increased more than 20-fold for diabetes lasting 15 years or more. The population-attributable risk for kidney failure was 21% for insulin-dependent diabetes and 21% for non-insulin-dependent diabetes (42% overall). A similar proportion of end-stage renal disease was attributed to diabetes in whites (44%) and in blacks (41%). Insulin-dependent diabetes had a relatively greater effect on the incidence of kidney failure in whites; in contrast, non-insulin-dependent diabetes had a relatively greater effect on kidney failure in blacks. Conclusions: Diabetes mellitus has a major effect on the incidence of end-stage renal disease in nonelderly adults. In black persons, diabetes may be responsible for a larger proportion of end-stage renal disease than is suggested by the use of clinical diagnoses of underlying renal disease made by patients' nephrologists. Prevention of end-stage renal disease associated with diabetes mellitus (both insulin-dependent and non- insulin-dependent diabetes) requires increased attention from laboratory and clinical researchers.
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U2 - 10.7326/0003-4819-121-12-199412150-00002
DO - 10.7326/0003-4819-121-12-199412150-00002
M3 - Article
C2 - 7978716
AN - SCOPUS:0027948488
VL - 121
SP - 912
EP - 918
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
SN - 0003-4819
IS - 12
ER -