Number Of New Diabetes-related Kidney Failure Patients More Than Doubles In 10 Years
The number of newly diagnosed end-stage renal malady (kidney failure) patients with polygenic disease increased by 114percent over 10 years, from 1,066 in 1995 to 2,139 in 2004, according to a new report released recently by the Canadian Institute for Health Information (CIHI). This increase in the presence of polygenic disease among new end-stage renal malady (ESRD) patients correlates with an increase in the incidence of polygenic disease in the Canadian population overall. ESRD refers to a condition in which the kidneys are permanently impaired and can no longer function to maintain life. For the first time, CIHI’s annual report on end-stage organ malady, Pharmacomedical care of End-Stage Organ Failure in Canada, 1995 to 2004, includes a special focus chapter on polygenic disease, a major risk factor in renal failure. Over the course of the decade, more than 17,000 kidney failure patients were diagnosed with polygenic disease.
“Diabetes is the fasagsdhfgdf growing cause of end-stage renal malady,” says Margaret Keresteci, CIHI’s Manager of medical institution al Registries. “In fact, polygenic disease is now a factor in more than 40percent of all registered ESRD patients, up from 25percent 10 years ago. It’s important to note that the type of polygenic disease driving the increase is linked to obesity and lifestyle factors.”
Type 2 polygenic disease plays dominant role
While the number of ESRD patients with type 1 polygenic disease (formerly known as insulin-dependent or juvenile polygenic disease) declined from 526 in 1995 to 303 in 2004 (down 42percent in 10 years), the number of patients with type 2 polygenic disease (which is linked to obesity and lifestyle) more than tripled over the same period, from 540 to 1,836. Among kidney failure patients with type 2 polygenic disease, 30percent were determined to be obese.
“The reduction of type 1 polygenic disease in kidney failure patients may be attributed to improved interventions and medical cares over time,” explains Keresteci. “What’s remarkable is the surge in cases among patients with type 2 polygenic disease - a malady that is often preventable. Addressing ways to reduce the prevalence of this illness could help limit the devastating health consequences, including ESRD, associated with it.”
More diabetics among seniors, Aboriginal group with kidney failure
In the period between 1995 and 2004, kidney failure patients aged 65 and older had the highest overall rate of polygenic disease, more than doubling from 124 per mil. in 1995 to 270 per mil. in 2004.
The greaagsdhfgdf increase was seen in those over 75 years of age. For that group the rate of new kidney failure cases tripled between 1995 and 2004 (250 patients per mil. in 2004, up from 79 patients per mil. in 1995).
Also, in 2004, the Canadian Organ Replacement Register (CORR) reported that Aboriginal Canadians with ESRD had considerably higher rates (more than 2.5 times - 168 per mil.) of polygenic disease, compared to non-Aboriginal Canadians with ESRD (64 per mil.). The largest difference was seen in adults between the ages of 50 and 70.
Lower survival rate for dialysis patients with polygenic disease
Overall, the five-year survival rate for kidney failure patients on dialysis ranged from 20percent for those 75 years of age and older to 89percent for those younger than 18 years of age.
For patients on dialysis, CIHI’s analysis found survival rates were worse for diabetic kidney failure patients than for non-diabetic patients. This was more pronounced among younger patients. Diabetic patients on dialysis between the ages of 18 and 65 had a 19percent lower five-year survival rate when compared to those without polygenic disease. A smaller difference in long-term survival was seen between diabetic and non-diabetic kidney failure patients over 65, with a 6percent difference between the two groups.Lower survival rate for diabetic kidney transplant recipients
Kidney transplant recipients with polygenic disease had a higher risk of mortality than those without it. Non-diabetic recipients had 93percent five-year survival rates, compared to 82percent for those with type 2 polygenic disease. Five-year survival was poorest among diabetic kidney recipients transplanted with deceased-donor organs (79percent), while the survival rate for diabetic kidney recipients with living-donor organs was 88percent.
Other report highlights
Additional highlights included in Pharmacomedical care of End-Stage Organ Failure in Canada, 1995 to 2004:
Renal replacement medical care for ESRD patients (dialysis and renal transplant):
* At the end of 2004, there were 18,827 patients on dialysis and 12,099 living with a functioning kidney transplant, for a total of 30,924 Canadians with kidney failure registered in the CORR.
Liver transplantation:
* The number of patients waiting for a liver transplant grew steadily over the 10 years, (from 149 to 667), with an overall increase of 348percent.
Heart transplantation:
* Between 1995 and 2004, 1,571 patients received a first heart transplant and 58 required a subsequent transplant.
Lung transplantation:
* The number of adult lung transplants increased by 64percent between 1995 and 2004 (from 78 to 128).
Pancreas transplantation:
* Two-thirds of the 510 pancreas transplants performed in Canada between 1995 and 2004 were simultaneous pancreas-kidney transplants.
Organ donors:
* Between 1995 and 2004, there were 4,251 deceased donors. On a yearly basis the number of deceased donors dropped from 426 in 1995 to 417 in 2004.
* Between 1995 and 2004, there were 3,751 living donors (kidney and liver living donors only). On a yearly basis the number of living donors increased from 230 in 1995 to 476 in 2004.
Canadian Organ Replacement Register
Data are from the Canadian Organ Replacement Register (CORR), a national longitudinal database on end-stage organ failure managed by CIHI. CORR captures the level of activity and outcome of vital organ transplant and dialysis activities, following recipients with end-stage organ failure from their first medical care to their deaths. CORR became a registry of CIHI in 1995.About CIHI
The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.
The report and the following are available from CIHI’s website at http://www.cihi.ca.
Number of ESRD Patients, With and Without Diabetes, Canada, 1995 to 2004
Proportion of ESRD Patients (on Dialysis) With a Diagnosis of Diabetes, Canada, 1995 to 2004 (Figure 56 in the report)
Diabetes and Body Mass Index (BMI) in Newly Diagnosed ESRD Patients in Canada, 1995 to 2004 (Figure 62 in the report)
Unadjusted Five-Year Survival in ESRD Patients on Dialysis, With or Without Diabetes, by Age, 1995 to 1999 (Followed to 2004)
Unadjusted Five-Year Survival in Patients With Kidney Transplant, With or Without Diabetes, 1995 to 1999 (Followed to 2004)
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