Chapter 16: Patients with Diabetic Nephropathy in Established Renal Failure: Demographics, Survival and Biochemical Variables

Diabetic nephropathy is now the most common renal disease leading to renal replacement therapy in developed countries. Within the UK, the number of DN patients accepted for RRT rose steadily in the 1990s especially in the African–Caribbean and South Asian populations. This may be related to the increased prevalence of Type 2 diabetes in the general population, the ageing population and the liberalisation of attitudes to acceptance for RRT. The overall rise has slowed in the last 4 years. DN patients starting RRT are likely to have more co-morbidity than other patients, in particular cardiovascular disease, and consequently worse survival on RRT. In recent years there has been some reduction in the high mortality of such patients, so the prevalence of diabetic nephropathy patients on RRT (currently lower than the percentage of incident patients, see Chapter 3) might increase.