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瑞典一项长达 38 年的全国性前瞻性研究显示,1 型糖尿病年轻患者终末期肾病累积发病率降低。

Decreasing Cumulative Incidence of End-Stage Renal Disease in Young Patients With Type 1 Diabetes in Sweden: A 38-Year Prospective Nationwide Study.

机构信息

Paediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden

Department of Internal Medicine, Ryhov County Hospital, Jönköping, Sweden.

出版信息

Diabetes Care. 2019 Jan;42(1):27-31. doi: 10.2337/dc18-1276. Epub 2018 Oct 23.

Abstract

OBJECTIVE

Diabetic nephropathy is a serious complication of type 1 diabetes. Recent studies indicate that end-stage renal disease (ESRD) incidence has decreased or that the onset of ESRD has been postponed; therefore, we wanted to analyze the incidence and time trends of ESRD in Sweden.

RESEARCH DESIGN AND METHODS

In this study, patients with duration of type 1 diabetes >14 years and age at onset of diabetes 0-34 years were included. Three national diabetes registers were used: the Swedish Childhood Diabetes Register, the Diabetes Incidence Study in Sweden, and the National Diabetes Register. The Swedish Renal Registry, a national register on renal replacement therapy, was used to identify patients who developed ESRD.

RESULTS

We found that the cumulative incidence of ESRD in Sweden was low after up to 38 years of diabetes duration (5.6%). The incidence of ESRD was lower in patients with type 1 diabetes onset in 1991-2001 compared with onset in 1977-1984 and 1985-1990, independent of diabetes duration.

CONCLUSIONS

The risk of developing ESRD in Sweden in this population is still low and also seems to decrease with time.

摘要

目的

糖尿病肾病是 1 型糖尿病的严重并发症。最近的研究表明,终末期肾病(ESRD)的发病率有所下降,或者 ESRD 的发病时间有所推迟;因此,我们想分析瑞典 ESRD 的发病率和时间趋势。

研究设计和方法

本研究纳入了病程>14 年且发病年龄为 0-34 岁的 1 型糖尿病患者。使用了三个国家糖尿病登记处:瑞典儿童糖尿病登记处、瑞典糖尿病发病率研究和国家糖尿病登记处。使用全国肾脏替代治疗登记处瑞典肾脏登记处来确定发生 ESRD 的患者。

结果

我们发现,在糖尿病病程长达 38 年的情况下,瑞典 ESRD 的累积发病率较低(5.6%)。1991-2001 年发病的 1 型糖尿病患者的 ESRD 发病率低于 1977-1984 年和 1985-1990 年发病的患者,且与糖尿病病程无关。

结论

在该人群中,瑞典发生 ESRD 的风险仍然较低,且似乎随着时间的推移而降低。

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