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Type 1 Diabetes With ESRD Prognosis Has Improved

Survival has increased in those with diabetes, renal disease receiving renal replacement therapy

MONDAY, Aug. 30 (HealthDay News) -- The survival of patients with type 1 diabetes and end-stage renal disease (ESRD) receiving renal replacement therapy (RRT) has improved since 1980, even with an increase in the age of patients starting RRT, according to a study in the August issue of Diabetes Care.

Mikko Haapio, M.D., of the Helsinki University Central Hospital in Finland, and colleagues followed 1,604 type 1 diabetes patients starting chronic RRT between 1980 and 2005 until death or end of follow-up on Dec. 31, 2007, and 1,556 control patients with glomerulonephritis who started RRT.

The investigators found that the median survival time of type 1 diabetes patients increased progressively from 3.60 years during 1980 to 1984 to greater than eight years during 2000 to 2005. The unadjusted relative risk of death was 0.55 during 2000 to 2005 compared to during 1980 to 1984, and the corresponding relative risk of death was 0.23 after adjustment for the most important variables. The adjusted relative risk decreased to 0.30 for individuals with glomerulonephritis. The researchers also noted that there has been an increase in the age of patients who start RRT since the 1980s.

"Survival of patients with type 1 diabetes and ESRD has improved since the 1980s despite a conspicuous increase in the age of patients who start RRT, suggesting not only true progress in dialysis therapy and overall treatment of patients with ESRD but possibly also improved management of diabetes," the authors write.

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