Why the study?
Diabetes mellitus is the leading cause of ESRD in Korea, prompting an update on the trends and characteristics of diabetic ESRD patients.
How do the prevalence, clinical characteristics, and mortality rates of diabetic CKD 5D compare to nondiabetic CKD 5D over a 20-year period?
How do the prevalence, clinical characteristics, and mortality rates of diabetic CKD 5D compare to nondiabetic CKD 5D over a 20-year period?
While diabetic ESRD patients historically had higher mortality than nondiabetic patients in South Korea, this trend reversed in 2021, though diabetic patients on peritoneal dialysis continue to face the highest mortality risk.
DM trends in Korean ESRD inform dialysis planning; leaves open targeted prevention trials.
Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.
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Kim et al. (2024) studied this question.
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