The number of diabetics diagnosed with kidney failure has more than doubled over ten years, the Canadian Institute for Health Information said in a new report released Wednesday.
Newly diagnosed cases of end-stage renal disease rose 114 per cent to more than 2,100 cases, from just under 1,100 cases between 1995 and 2004, the CIHI reported.
This increase in the presence of diabetes among patients with end-stage renal disease, or ESRD, correlates with an increase in the incidence of diabetes in the Canadian population.
ESRD refers to a condition in which the kidneys are permanently impaired and can no longer function to maintain life.
"Diabetes is the fastest growing cause of end-stage renal disease," said Margaret Keresteci, CIHI's manager of clinical registries.
"In fact, diabetes is now a factor in more than 40 per cent of all registered ESRD patients, up from 25 per cent 10 years ago. It's important to note that the type of diabetes driving the increase is linked to obesity and lifestyle factors."
The number of ESRD patients with type 1 diabetes, formerly known as insulin-dependent or juvenile diabetes) declined from 526 in 1995 to 303 in 2004.
In contrast, the number of patients with type 2 diabetes, which is linked to obesity and lifestyle, more than tripled over the same period, from 540 to 1,836.
Thirty per cent of kidney failure patients with type 2 diabetes were determined to be obese.
"The reduction of type 1 diabetes in kidney failure patients may be attributed to improved interventions and treatments over time," Keresteci said.
"What's remarkable is the surge in cases among patients with type 2 diabetes -- a disease that is often preventable. Addressing ways to reduce the prevalence of this illness could help limit the devastating health consequences, including ESRD, associated with it," she said/
Seniors and aboriginal Canadians have the highest rates of diabetes-related kidney failure, according to the CIHI report.
In the period between 1995 and 2004, kidney failure patients aged 65 and older had the highest overall rate of diabetes, more than doubling from 124 per million in 1995 to 270 per million in 2004.
The greatest increase was seen in those over 75 years of age.
For that group, the rate of new kidney failure cases tripled between 1995 and 2004, going from 79 patients per million in 1995 to 250 in 2004.
The Canadian Organ Replacement Register also reported that in 2004, Aboriginal Canadians with ESRD had considerably higher rates of diabetes compared to their non-Aboriginal counterparts.
Overall, the five-year survival rate for kidney failure patients on dialysis ranged from 20 per cent, among those 75 years of age and older, to 89 per cent for those younger than 18 years of age.
The report found that kidney failure patients with diabetes have lower survival rates than those without diabetes, whether they are on dialysis or have received an organ transplant.
This was more pronounced among younger patients.
Diabetic patients on dialysis between the ages of 18 and 65 had a 19 per cent lower five-year survival rate when compared to those without diabetes.
A smaller difference in long-term survival was seen between diabetic and non-diabetic kidney failure patients over 65, with a 6 per cent difference between the two groups.
Meanwhile, kidney transplant recipients with diabetes had a higher risk of mortality than those without it.
Non-diabetic recipients had 93 per cent five-year survival rates, compared to 82 per cent for those with type 2 diabetes.
Five-year survival was lowest among diabetic kidney recipients transplanted with deceased-donor organs, at 79 per cent, while the survival rate for diabetic kidney recipients with living-donor organs was 88 per cent.
The report, Treatment of End-Stage Organ Failure in Canada, 1995 to 2004, also provided data on other types of transplants. Among its key findings:
- At the end of 2004, there were 18,827 patients on dialysis and 12,099 living with a functioning kidney transplant, for a total of 30,924 Canadians with kidney failure registered in the Canadian Organ Replacement Register
- The number of patients waiting for a liver transplant grew from 149 to 667 over ten years, with an overall increase of 348 per cent
- Between 1995 and 2004, 1,571 patients received a first heart transplant and 58 required a subsequent transplant.
- The number of adult lung transplants increased by 64 per cent, from 78 to 128, between 1995 and 2004
- Two-thirds of the 510 pancreas transplants performed in Canada between 1995 and 2004 were simultaneous pancreas-kidney transplants
- On a yearly basis the number of deceased donors dropped from 426 in 1995 to 417 in 2004
