A survey of the NIH CAPD Registry population with end-stage renal disease attributed to diabetic nephropathy.
Lindblad, A.S.; Nolph, K.D.; Novak, J.W.; Friedman, E.A.
J Diabet Complications
Adult; Age Factors; Diabetic Nephropathies; Female; Humans; Hypoglycemic Agents; Insulin; Kidney Failure, Chronic; Male; Middle Aged; National Institutes of Health (U.S.); Peritoneal Dialysis, Continuous Ambulatory; Registries; United States
A survey of CAPD/CCPD patients with end-stage renal disease attributed to diabetes mellitus done by the USA NIH CAPD Registry obtained information from 499 patients. These data suggest that in diabetics with renal insufficiency, the time interval from age at diagnosis of diabetes to initiation of dialysis decreases as the age of diagnosis increases. Mean interval from the time of diabetes diagnosis to CAPD or CCPD initiation was 25 years for patients less than 20 years of age at diagnosis and 17 years for patients greater than or equal to 30 years of age. This trend is independent of the type of diabetes management and appeared to be independent of the type of diabetes. Patients were categorized on the basis of pre- and post-CAPD management of hyperglycemia. There were several associations noted between type of diabetes therapy and clinical findings: A higher proportion of legally blind patients had used insulin only (33%) compared with patients never using insulin (10%) and 78% of patients using insulin only were white compared with 49% among the never on insulin group. This latter result indicates that race influences the type of diabetes and/or progression of diabetes to renal insufficiency. Patients on insulin only reported parents and/or siblings with diabetes less often than did patients using insulin and oral agents, some insulin, or never any insulin to manage their diabetes. The authors also noted that peritonitis rates were not increased in those patients who added insulin to dialysis solutions.