This study aimed to estimate the long-term risk of End-Stage Kidney Disease (ESKD) in type 2 diabetes. We included 1,113,201 people with type 2 diabetes registered on the Australian National Diabetes Services Scheme (NDSS) followed from 2002 until 2013. The NDSS was linked to the Australia and New Zealand Dialysis and Transplant Registry and the National Death Index to obtain incident renal replacement therapy (RRT) and death, respectively. Between 2002 and 2013, 7,592 NDSS registrants initiated RRT over 7,839,075 person-years of follow up. The incidence of RRT increased with increasing duration of diabetes. In the first 10-15 years after onset of diabetes, incidence of RRT was highest in those with older age at onset of diabetes. However, over longer durations of diabetes, the cumulative incidence of RRT became higher in those with younger onset diabetes. When “total” incidence of ESKD (RRT and deaths attributed to ESKD without RRT) was considered, the predicted lifetime risks of renal failure (until age 100) were 20.1%, 16.1%, 11.6%, 7.7%, 5.4%, and 4.2% in those with diabetes onset between ages 10-29, 30-39, 40-49, 50-59, 60-69, and 70-79, respectively. Thus, the long-term risk of ESKD in type 2 diabetes is high, which disproportionately affects those with younger-onset type 2 diabetes as they are more likely to survive to longer diabetes durations.
J.I. Morton: None. D. Liew: None. S. McDonald: None. J.E. Shaw: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Mylan, Sanofi. Research Support; Self; AstraZeneca. Speaker’s Bureau; Self; Eli Lilly and Company, Mylan. D.J. Magliano: None.
Australian Government Research Training Program (to J.I.M.); Monash University (to J.I.M.)