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fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Nitsch, D; Burden, R (2006)
Publisher: Renal Association UK
Languages: English
Types: Book
Subjects:

Classified by OpenAIRE into

mesheuropmc: urologic and male genital diseases
Diabetic nephropathy is now the most common renal disease leading to renal replacement therapy in developed countries1,2,3,4. Within the UK, the number of DN patients accepted for RRT rose steadily in the 1990s5 especially in the African–Caribbean and South Asian populations3,4,5,6. This may be related to the increased prevalence of Type 2 diabetes in the general population, the ageing population and the liberalisation of attitudes to acceptance for RRT5,7. The overall rise has slowed in the last 4 years8 . DN patients starting RRT are likely to have more co-morbidity than other patients, in particular cardiovascular disease, and consequently worse survival on RRT9,10,11. In recent years there has been some reduction in the high mortality of such patients, so the prevalence of diabetic nephropathy patients on RRT (currently lower than the percentage of incident patients, see Chapter 3) might increase12,13. The National Service Frameworks for Diabetes14 and for Renal Services15 have highlighted the importance of the primary prevention of DN in diabetic patients by early detection and aggressive management of hypertension, glucose control and cardiovascular risk factors and of the timely referral (recommendation >1 yr before RRT) of those with progressive renal disease in order to plan for RRT. 251 There is a key policy drive to reduce health inequalities in England16. In the UK there is evidence that diabetic patients in more socially deprived areas have higher all cause mortality even after adjustment for smoking and blood pressure9 , and lower rates of attendance at GP and hospital clinics17. The UK Renal Registry 2003 Report highlighted the possible role of social deprivation in the context of DN. This chapter examines the characteristics of patients developing established renal failure from DN, their access to modalities of treatment and their survival on RRT relative to other incident patients. It also includes data on quality of care (HbA1c, cholesterol and blood pressure). These analyses were undertaken before individual patient data from the Scottish Registry became available and therefore only includes England and Wales.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. ERA-EDTA Registry. [http://www.era-edta-reg.org/ index.jsp]; last accessed on 28.04.2005.
    • 2. US States Renal data system [http://www.usrds.org/]; last accessed on 28.04.2005.
    • 3. Ritz E, Rychlic I, Locatelli F, Halimi S. End-stage renal failure in type 2 diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis 1999;34(5):795-808.
    • 4. Zimmet P, Alberti KGMM, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782-787.
    • 5. Feest TG, Rajamahesh J, Byrne C, Ahmad A, Ansell D, Burden R, Roderick PJ. Trends in adult renal replacement therapy in the UK: 1982-2002. QJM. 2005;98(1):21-8.
    • 6. Roderick PJ, Raleigh VS, Hallam L, Mallick NP. The need and demand for renal replacement therapy in ethnic minorities in England. J Epidemiol Community Health. 1996;50(3):334-9.
    • 7. Gansevoort RT, van der Heij B, Stegeman CA, de Charro FT, Nieuwenhuizen MG, de Zeeuw D, de Jong PE. Trends in the incidence of treated end-stage renal failure in The Netherlands: hope for the future? Kidney Int Suppl. 2004;(92):S7-10.
    • 8. Ansell D, Feest T, UK Renal Registry Report 2004, [www.renalreg.com/], last accessed on 28.08.2005.
    • 9. Chandna SM, Schulz J, Lawrence C, Greenwood RN, Farrington K. Is there a rationale for rationing chronic dialysis? A hospital based cohort study of factors affecting survival and morbidity. BMJ. 1999; 318:217-23.
    • 10. Lok CE, Oliver MJ, Rothwell DM, Hux JE. The growing volume of diabetes related dialysis: a population based study. Nephrol Dial Transplant 2004;19: 3098-3103.
    • 11. Chaturvedi N, Jarrett J, Shipley MJ, Fuller JH. Socioeconomic gradient in morbidity and mortality in people with diabetes: cohort study findings from the Whitehall Study and the WHO Multinational Study of Vascular Disease in Diabetes. BMJ. 1998; 316:100-5.
    • 12. Van Dijk PC, Jager KJ, Stengel B, Gronhagen-Riska C, Feest TG, Briggs JD. Renal replacement therapy for diabetic end-stage renal disease: data from 10 registries in Europe (1999-2000). Kidney Int 2005;67: 1489-99.
    • 13. Elinder CG, Jones E, Briggs JD, Mehls O, Mendel S, Piccoli G, Rigden SPA, Pinto dos Santos J, Simpson K, Tsakiris D, Vanrenterghem Y. Improved survival in renal replacement therapy in Europe between 1975 and 1992. An ERA-EDTA Registry Study. Nephrol Dial Transplant 1999;14:2351-2356.
    • 14. Department of Health: National Service Framework for Diabetes: Delivery Strategy, 2003.
    • 15. Department of Health Renal Team. The National Service Framework for Renal Services. Part 1: Dialysis and Transplantation, 2004.
    • 16. Department of Health: Tackling health inequalities. A Programme for Action. [http://www.dh.gov.uk/ assetRoot/04/01/93/62/04019362.pdf;2003]; last accessed on 12.11.2005.
    • 17. Goyder EC, McNally PG, Botha JL. Inequalities in access to diabetes care: evidence from a historical cohort study. Qual Health Care. 2000;9(2):85-9.
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    • 20. Bhopal R, Hayes L, White M, Unwin N, Harland J, Ayis S, Alberti G. Ethnic and socio-economic inequalities in coronary heart disease, diabetes and risk factors in Europeans and South Asians. J Public Health Med. 2002;24(2):95-105.
    • 21. Evans JM, Newton RW, Ruta DA, MacDonald TM, Stevenson RJ, Morris AD. Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database. BMJ. 1999;319(7202):83-6.
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    • 24. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, McCullough PA, Kasiske BL, Kelepouris E, Klag MJ, Parfrey P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation 2003;108:2154-2169.
    • 25. Locatelli F, Pozzoni P, Del Vecchio L. Renal replacement therapy in patients with diabetes and end-stage renal disease. J Am Soc Nephrol 2004;15 Suppl 1:S25-9.
    • 26. Oniscu GC, Schalkwijk AAH, Johnson RJJ, Brown H, Forsythe JLR. Equity of access to renal transplant waiting list and renal transplantation in Scotland: cohort study. BMJ 2003;1261-5.
    • 27. Ansell D, Feest T, UK Renal Registry Report 2001, Chapter 10: Listing for Renal Transplantation [www.renalreg.com/], last accessed on 28.08.2005
    • 28. Wilson SR, Vakili BA, Sherman W, Sanborn TA, Brown DL. Effect of diabetes on long-term mortality following contemporary percutaneous coronary intervention: analysis of 4284 cases. Diabetes Care 2004; 27(5):1137-42.
    • 29. Ohtake T, Kobayashi S, Moriya H, Negishi K, Okamoto K, Maesato K, Saito S. High prevalence of occult coronary artery stenosis in patients with chronic kidney disease at the initiation of renal replacement therapy: An angiographic examination. J Am Soc Nephrol 2005;16:1141-8.
    • 30. Kalantar-Zadeh K, Abbott KC, Salahudeen AK, Kilpatrick RD, Horwich TB. Survival advantages of obesity in dialysis patients. Am J Clin Nutr. 2005; 81(3):543-54.
    • 31. Kalantar-Zadeh K, Kilpatrick RD, McAllister CJ, Greenland S, Kopple JD. Reverse epidemiology of hypertension and cardiovascular death in the hemodialysis population: the 58th annual fall conference and scientific sessions. Hypertension. 2005;45(4):811-7.
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