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Non-insulin-dependent diabetes and renal replacement therapy
A Grenfell1, M Bewick, V Parsons
1Diabetic Department, King's College Hospital, London, UK.
Summary
Non-insulin-dependent diabetes mellitus (NIDDM) patients represent a significant portion of those needing renal replacement therapy. NIDDM patients are older, have shorter diabetes duration, and a higher prevalence of non-diabetic renal disease compared to insulin-dependent diabetes mellitus (IDDM) patients.
Area of Science:
- Nephrology
- Endocrinology
- Diabetology
Background:
- Renal replacement therapy (RRT) reports predominantly focus on insulin-dependent diabetes mellitus (IDDM).
- Limited data exists on renal failure in non-insulin-dependent diabetes mellitus (NIDDM) patients.
Purpose of the Study:
- To investigate the characteristics and outcomes of NIDDM patients undergoing RRT.
- To compare NIDDM patients with IDDM patients receiving RRT.
Main Methods:
- Retrospective analysis of diabetic patients treated with RRT since 1974.
- Comparison of demographic data, diabetes history, renal disease etiology, and survival rates between NIDDM and IDDM groups.
Main Results:
- NIDDM constituted 32% of RRT patients, were older, and had a shorter diabetes duration than IDDM patients.
- NIDDM patients showed a higher prevalence of non-European ethnicity and non-diabetic renal disease.
- Transplant survival was poorer in NIDDM (23%) versus IDDM (57%) at 2 years; dialysis survival was similar.
Conclusions:
- NIDDM patients undergoing RRT are often older, from minority ethnic groups, and may have non-diabetic renal disease.
- Diabetic complications are similarly prevalent in both NIDDM and IDDM patients with diabetic nephropathy.
- Outcomes for NIDDM patients on RRT, particularly post-transplantation, are worse than for IDDM patients.