Endocrine Abstracts (2006) 11 P288

Mortality risks of diabetic patients who reach end stage renal disease (ESRD) in the united states: age and gender differences

AG Stack & L O’Shea

Regional Kidney Centre, Department of Medicine, Letterkenny, General Hospital, Donegal, Ireland.

Prior studies have demonstrated that diabetes as a cause of or contributing factor to end stage renal disease (ESRD) has a detrimental impact on survival. What is unclear is whether this effect varies by age and gender.

Methods: The objective of this study was to evaluate mortality differences by age and gender among diabetic and non-diabetic ESRD patients in a national cohort. Data on all new ESRD patients (n=451,296) who were initiated on dialysis in the U.S. between 5/1995-12/2000 and followed until 12/2001 were obtained from the U.S. Renal Data System. Mortality risks were compared for diabetic and non-diabetic patients using Cox regression adjusting for sociodemographic characteristics and 18 comorbid indicators recorded at ESRD onset. The cohort was stratified by age group (<50, 50–70 and >70 yrs) and gender.

Results: The adjusted relative hazard ratios (RR) for death for Diabetic (DM) vs non-Diabetic (Non-DM) patients are shown.

Adjusted RR of Death (Diabetic vs Non Diabetic)
Group< 50 yrs50–70 yrs> 70 yrs
All Patients1.001.33**1.001.10**1.001.05*
Male1.001.21**1.001.05*1.001.11 **
Female1.001.51 **1.001.14**1.000.93
*P< 0.01, **P<0.001

Conclusions: Mortality risks were significantly greater in diabetic than non-diabetic ESRD patients. These risks were greatest for patients <50 yrs and females. Whether these differences represent inequalities in delivered diabetic care or greater disease severity deserves further attention.

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