The Changing Epidemiology of Renal Replacement Therapy in Diabetes. Results from the Diabetes Impact Study 2013, Denmark

Aims : We present an investigation of first-time renal replacement therapy in patients with diabetes in Denmark 2000 through 2011. Methods: The Diabetes Impact Study 2013 is based on all registrants in the Danish National Diabetes Register as of July 3rd 2013 (n=497,232). Record linkage with the Danish National Patient Register was used to define the first date of experiencing complications including dialysis and/or kidney transplant. Results: The prevalence of diabetes rose exponentially due to increasing incidence of diabetes and declining mortality. Even though the rate of developing complications (grouped into complications of intermediate and major impact) decreased, the rate of first time dialysis and first time kidney transplantation remained constant. Conclusions: In spite of reducing the risk of developing long term complications in diabetes, the rate of commencing renal replacement therapy has remained constant. Further in-depth studies are needed to explain this unexpected finding.