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ESRD attributed to diabetes declining in US
CDC. MMWR. 2010;59:1361-1366.
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Calculated estimates denoted a 35% decrease in the incidence of diabetes-related end-stage renal disease in the United States from 1996 to 2007.
CDC researchers investigated this decline in ESRD attributed to diabetes by examining US Renal Data System and Behavioral Risk Factor Surveillance System data from 1996 to 2007 for all states, Washington, D.C. and Puerto Rico.
The number of adults aged at least 18 years in the United States and Puerto Rico who initiated treatment for diabetes-related ESRD rose considerably from 32,716 to 48,712 during the study period (P<.001), although data indicate that these increases have recently subsided.
In 2007, approximately 40% of new ESRD cases attributed to diabetes surfaced in the South, and approximately 20% in each of the three other US regions. The rate of diabetes-related ESRD among people with diagnosed diabetes, however, was significantly higher in the West, with 219.2 cases occurring per 100,000 people, compared with the Northeast (182.6 per 100,000).
During the study period, age-adjusted incidence declined from 304.5 per 100,000 to 199.1 per 100,000 people (P<.001), with all regions experiencing substantial decreases. However, while most states experienced declines, the researchers noted that not all reductions were significant.
In contrast, incidence climbed considerably in Puerto Rico from 1996 to 2003. A decline occurred during 2003 to 2007 (P=.3), but the researchers said that it was not significant.
Reasons for the noted decreases in incidence of diabetes-related ESRD are unclear, but reductions in risk factors for kidney failure or better treatment with new pharmacologic agents may be responsible, according to the researchers. Continued prevention efforts, however, remain important.
“Effective interventions to improve control of blood sugar, hypertension and lipid levels might slow the progression of kidney disease, and effective community-based approaches to prevent obesity and increase physical activity might reduce the incidence of type 2 diabetes,” the researchers wrote.
They highlighted the joint CDC and state prevention and control efforts and noted that the agency is establishing a Chronic Kidney Disease Surveillance System to monitor burden of disease in the United States.
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