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Diabetes-related ESRD incidence in U.S. population continues to decline

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The incidence of diabetes-related end-stage renal disease has decreased in all age groups, from 343.2 per 100,000 people with diabetes in 1996 to 197.7 per 100,000 people with diabetes in 2006 — or 3.9% per year, according to data from the U.S. Renal Data System.

Similar decreasing trends were seen in all age groups, sexes and races/ethnicities.

These findings suggest that current efforts to prevent ESRD may be successful, researchers said.

Researchers used U.S. Renal Data System data on individuals who had diabetes listed as a primary diagnosis. All had initiated ESRD treatment between 1990 and 2006. Incidence of ESRD and treatment was calculated using the estimated U.S. population with diabetes from the National Health Interview Survey and age adjustments using using the 2000 U.S. standard population.

In 1990, 17,727 people began diabetes-related ESRD treatment compared with 48,215 in 2006.

From 1990 to 1996, the age-adjusted diabetes-related ESRD incidence increased from 299 per 100,000 people with diabetes to 343.2 per 100,000 people with diabetes (P=.45).

Among people with diabetes aged 45 years and younger, diabetes-related ESRD incidence decreased by 4.3% per year (P<.01) from 1990 to 2006. Among older individuals, incidence increased in the 1990s but decreased after — 3.9% per year among individuals aged 65 to 74 (P<.01) and 2.1% per year (P=.02) among individuals aged 75 or older.

From 1997 to 2006, diabetes-related ESRD incidence among Hispanics did not decrease as it did among whites. In 2006, the age-adjusted diabetes-related ESRD incidence among Hispanics was 1.5 times greater than that for whites, and the incidence among blacks was two times greater.

Researchers attributed the decreases to reductions in the prevalence of ESRD risk factors, improved treatment and care and other factors. Future efforts should include intervention programs to raise awareness about ESRD and promote early diagnosis, prevention and control of ESRD risk factors, they said.

Burrows NR. Diabetes Care. 2010;33:73-77.