Hong Kong Journal of Nephrology

Volume 3 Number 2, 2001

Renal replacement therapy for patients with diabetes mellitus in Hong Kong

Bo-Ying CHOY1, Yiu-Wing HO2, Ka-Foon CHAU3, Chi-Bon LEUNG4, Wai-Kei TSANG5, Siu-Fai LUI4
Departments of Medicine,
1 Queen Mary Hospital;
2 United Christian Hospital;
3 Queen Elizabeth Hospital;
4 Prince of Wales Hospital; and
5 Princess Margaret Hospital, Hong Kong.

Diabetes mellitus is becoming the most common cause of end-stage renal failure in Hong Kong. This review is based on data from the Hong Kong Renal Registry from 1995 through 2000. As of March 31, 2000, a total of 1026 patients with diabetes mellitus were on renal replacement therapy. A total of 809 patients had diabetic nephropathy as primary disease and 217 had diabetes mellitus as comorbidity. The prevalence of renal replacement therapy for patients with diabetes mellitus was 151 per million population. For the year ending March 31, 2000, there were 342 new patients with diabetes mellitus requiring renal replacement therapy. Of all the patients on renal replacement therapy, 23% were diabetic. The patients with diabetes mellitus were older (median age, 63 years), and had a higher incidence of hypertension (85%), ischemic heart disease (24%), cerebrovascular disease (9%), and peripheral vascular disease (3%). The modes of renal replacement therapy for patients with diabetes mellitus were peritoneal dialysis (81%), hemodialysis (9%), and transplant (10%). The annual crude mortality rate of patients with diabetes mellitus was 16% (peritoneal dialysis, 17%; hemodialysis, 18%; transplant, 1%) compared with 6% for patients without diabetes mellitus (peritoneal dialysis, 8%; hemodialysis, 12%; transplant, 1%). The major causes of death were cardiovascular disease (33%), infection (28%), and cerebrovascular event (8%). The 1- and 5-year survival rates of dibetic patient were 89% and 32% for peritoneal dialysis, 73% and 26% for hemodialysis, and 94% and 87% for transplant, respectively. The 1- and 5-year graft survival rates were 88% and 82% (death not censored), and 91% and 91% (death censored), respectively. (Hong Kong J Nephrol 2001;3(2):89-96)

Key words: Diabetes mellitus (DM), Kidney transplantation (TX), Peritoneal dialysis (PD), Renal replacement therapy (RRT), Survival analysis

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