MedWire News: People in Finland with Type 2 diabetes and on renal dialysis are living longer, a survey of the population from 1995 to 2005 has shown.
The most likely explanation for the improved survival is better disease and risk-factor control rather than more kidney transplantations, say the study authors writing in the journal Nephrology Dialysis Transplantation.
Marjo Kervinen (Kuopio University Hospital, Finland) and colleagues investigated trends in survival among Type 2 diabetic patients on renal replacement therapy between 1995 and 2005.
Using the Finnish Registry for Kidney Diseases, they identified 314 patients who started dialysis in 1995–9 and 583 who started in 2000–5. All patients had Type 2 diabetes and were followed-up until 31 December 2006.
The median survival time was 2.23 years in the earlier cohort and 2.99 years in the later cohort, a statistically significant difference. After adjusting for age and gender, the 2000–5 cohort had a 26% lower risk for dying relative to the 1995–9 cohort, Kervinen and colleagues report.
The mortality risk fell over time to a similar extent in both men and women but was more marked in older individuals, with hazard ratios of 0.67 and 0.69 in those aged 55–64 years and 65–74 years, respectively, for the later versus earlier cohorts.
Patients in the 2000–5 cohort tended to be more obese but have lower total and low-density lipoprotein cholesterol and serum albumin levels compared with the 1995–9 cohort, the authors remark. Adjusting for baseline differences did not alter the main finding, say the authors, who note that the likelihood of receiving a kidney transplantation remained low over the entire study duration.
The authors say that the improved survival observed in their study is a result of improved diabetic care and successful preventive measures, noting that Type 2 diabetic patients “are increasingly treated with effective blood pressure drugs” and that their glycemic control “has been more targeted to the best known goals with modern medication and methods.”
They add: “A closer study of individual risk factors for mortality would be important to identify the factors affecting mortality the most. This could help improve survival of Type 2 diabetic patients on renal replacement therapy in the future.”
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