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Trends in the epidemiology and care of diabetes mellitus-related end-stage renal disease in France, 2007–2011

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Abstract

Aims/hypothesis

The aim was to study geographic variations and recent trends in the incidence of end-stage renal disease (ESRD) by diabetes status and type, and in patient condition and modalities of care at initiation of renal replacement therapy.

Methods

Data from the French population-based dialysis and transplantation registry of all ESRD patients were used to study geographic variations in 5,857 patients without diabetes mellitus, 227 with type 1 diabetes mellitus, and 3,410 with type 2. Trends in incidence and patient care from 2007 to 2011 were estimated.

Results

Age- and sex-adjusted incidence rates were higher in the overseas territories than in continental France for ESRD unrelated to diabetes and related to type 2 diabetes, but quite similar for type 1 diabetes-related ESRD. ESRD incidence decreased significantly over time for patients with type 1 diabetes (−10% annually) and not significantly for non-diabetic patients (0.2%), but increased significantly for patients with type 2 diabetes (+7% annually until 2009 and seemingly stabilised thereafter). In type 2 diabetes, the net change in the absolute number was +21%, of which +3% can be attributed to population ageing, +2% to population growth and +16% to the residual effect of the disease. Patients with type 2 diabetes more often started dialysis as an emergency (32%) than those with type 1 (20%) or no diabetes.

Conclusions/interpretation

The major impact of diabetes on ESRD incidence is due to type 2 diabetes mellitus. Our data demonstrate the need to reinforce strategies for optimal management of patients with diabetes to improve prevention, or delay the onset, of diabetic nephropathy, ESRD and cardiovascular comorbidities, and to reduce the rate of emergency dialysis.

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Abbreviations

eGFR:

Estimated GFR

ERBP:

European Renal Best Practice

ESA:

Erythropoiesis-stimulating agent

ESRD:

End-stage renal disease

CKD:

Chronic kidney disease

HD:

Haemodialysis

PD:

Peritoneal dialysis

pmp:

Per million population

REIN:

Renal Epidemiology and Information Network

RRT:

Renal replacement therapy

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Acknowledgements

We thank all registry participants, especially the nephrologists and professionals who collected the data and conducted the quality control studies. The dialysis centres participating in the registry are listed in the annual report: www.agence-biomedecine.fr/IMG/pdf/rapport_reinvdef.pdf. We also thank Bayer Florian (Biomedicine Agency, the French REIN Registry, France), for help with drawing maps.

Funding

FGAA is supported by research grants from the Société Francophone du Diabète (French-Speaking Diabetes Society).

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

FGAA designed the study, acquired data, carried out statistical analyses, interpreted data and drafted the manuscript. BS, CC, TH, EV, AF-C, CJ and LF contributed to the conception and design of the study and interpretation of data. All authors critically revised earlier drafts of the manuscript and approved the final version of the manuscript.

Author information

Authors and Affiliations

  1. The French REIN Registry, Biomedicine Agency, Saint Denis La Plaine, France

    Frank G. A. Assogba, Cécile Couchoud & Christian Jacquelinet

  2. Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, 12 rue du Val d’Osne, 94415, Saint-Maurice Cedex, France

    Frank G. A. Assogba

  3. Department of Nephrology, School of Medicine, University Hospital, Strasbourg, France

    Thierry Hannedouche

  4. Department of Nephrology, St Joseph St Luc Hospital, Lyon, France

    Emmanuel Villar

  5. Biostatistics Health Laboratory, CNRS, UMR 5558, University Claude Bernard Lyon 1, Villeurbanne, France

    Emmanuel Villar

  6. Clinical Epidemiology, School of Medicine, University Hospital, Inserm CIC-EC, Vandoeuvre-lès-Nancy, France

    Luc Frimat

  7. Department of Nephrology, School of Medicine, University Hospital, Vandoeuvre-lès-Nancy, France

    Luc Frimat

  8. Department of studies on diseases and patients, French National Health Insurance Fund for Salaried Workers, Paris, France

    Anne Fagot-Campagna

  9. Centre for Research in Epidemiology and Population Health, Diabetes, Obesity, and Chronic Kidney Disease Epidemiology Team, Inserm U1018, Villejuif, France

    Bénédicte Stengel

  10. Paris-Sud University, UMRS 1018, 94807, Villejuif, France

    Bénédicte Stengel

Authors
  1. Frank G. A. Assogba
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  2. Cécile Couchoud
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  3. Thierry Hannedouche
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  4. Emmanuel Villar
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  5. Luc Frimat
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  6. Anne Fagot-Campagna
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  7. Christian Jacquelinet
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  8. Bénédicte Stengel
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Consortia

on behalf of the French Renal Epidemiology and Information Network (REIN) Registry

Corresponding author

Correspondence to Frank G. A. Assogba.

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Assogba, F.G.A., Couchoud, C., Hannedouche, T. et al. Trends in the epidemiology and care of diabetes mellitus-related end-stage renal disease in France, 2007–2011. Diabetologia 57, 718–728 (2014). https://doi.org/10.1007/s00125-014-3160-9

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  • DOI: https://doi.org/10.1007/s00125-014-3160-9

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