Incidence and relative risk of renal replacement therapy (RRT) in people with and without diabetes between 2002 and 2016 in a German region

Objective:

The aim of this study was 1) to analyse the incidence of renal replacement therapy (RRT) among persons with and without diabetes as well as relative risk due to diabetes and 2) to investigate the corresponding time trends for the period 2002 – 2016.

Methods:

We analysed data for 2002 – 2016 from one dialysis centre of a region in North-Rhine Westphalia in Germany (about 310,000 inhabitants). We estimated the age-sex-standardised incidence rates (IR) for first chronic RRT among adults with and without diabetes and the corresponding relative risks. The time trend was analysed using Poisson regression models.

Results:

In total, 1107 persons (61.2% male; mean age 71.6 years, 48.7% with diabetes) had a first chronic RRT between 2002 and 2016. During the study period, the IR in the population with diabetes was 93.6 (95% CI: 50.4 – 136.7) in 2002 and 140.5 (95% CI: 80.6 – 200.4) per 100,000 person years in 2016. In the population without diabetes the IR was substantially lower and reached 17.3 (95% CI: 10.9 – 23.6) in 2002 and 24.6 (95% CI: 17.5 – 31.7) in 2016. The relative risk comparing people with and without diabetes was 3.57 (95% CI: 3.09 – 4.13). We found no significant change of the IRs during the observation period in either the population with or without diabetes and thus the relative risk also remained constant.

Conclusions:

In this population based study we found a 3.6-fold increased risk for first chronic RRT among people with compared to those without diabetes. The IRs in both populations remained constant during the study period.