Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study
Background: There are limited population-wide trend data on kidney failure and kidney replacement therapy (KRT) in people with diabetes. We conducted a retrospective cohort study to report incidence trends of kidney failure and KRT and related mortality in people with diabetes in Hong Kong between 2...
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Elsevier
2021-06-01
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Series: | The Lancet Regional Health. Western Pacific |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606521000742 |
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Article |
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DOAJ |
language |
English |
format |
Article |
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DOAJ |
author |
Hongjiang Wu, PhD Eric S.H. Lau, PhD Aimin Yang, PhD Cheuk-Chun Szeto, MD Ronald C.W. Ma, FRCP Alice P.S. Kong, MD Elaine Chow, PhD Wing-Yee So, MD Juliana C.N. Chan, MD Andrea O.Y. Luk, MD |
spellingShingle |
Hongjiang Wu, PhD Eric S.H. Lau, PhD Aimin Yang, PhD Cheuk-Chun Szeto, MD Ronald C.W. Ma, FRCP Alice P.S. Kong, MD Elaine Chow, PhD Wing-Yee So, MD Juliana C.N. Chan, MD Andrea O.Y. Luk, MD Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study The Lancet Regional Health. Western Pacific diabetes kidney failure kidney replacement therapy trend incidence mortality |
author_facet |
Hongjiang Wu, PhD Eric S.H. Lau, PhD Aimin Yang, PhD Cheuk-Chun Szeto, MD Ronald C.W. Ma, FRCP Alice P.S. Kong, MD Elaine Chow, PhD Wing-Yee So, MD Juliana C.N. Chan, MD Andrea O.Y. Luk, MD |
author_sort |
Hongjiang Wu, PhD |
title |
Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study |
title_short |
Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study |
title_full |
Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study |
title_fullStr |
Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study |
title_full_unstemmed |
Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort study |
title_sort |
trends in kidney failure and kidney replacement therapy in people with diabetes in hong kong, 2002-2015: a retrospective cohort study |
publisher |
Elsevier |
series |
The Lancet Regional Health. Western Pacific |
issn |
2666-6065 |
publishDate |
2021-06-01 |
description |
Background: There are limited population-wide trend data on kidney failure and kidney replacement therapy (KRT) in people with diabetes. We conducted a retrospective cohort study to report incidence trends of kidney failure and KRT and related mortality in people with diabetes in Hong Kong between 2002 and 2015. Methods: We used territory-wide electronic medical records including laboratory, diagnostic and procedural data to identify people with kidney failure and KRT. We used Joinpoint regression models to estimate the average annual percent change (AAPC) of kidney failure and KRT incidence for entire study period, and annual percent change (APC) for each linear trend segment, along with 1-year and 5-year mortality rates. Findings: During 4.9 million person-years of follow-up of 712,222 people with diabetes, 31,425 developed kidney failure, among whom 23.0% (n=7,233) received KRT. The incidence of kidney failure declined by 46.8% from 2002 to 2007 (APC: -11.6, 95% CI: -16.3, -6.7), then flattened from 2007 to 2015 (APC: -0.9, 95% CI: -3.1, 1.3). The incidence of KRT remained constant (AAPC: -1.6, 95% CI: -4.4, 1.2). The 1-year mortality rates declined statistically significantly after both kidney failure and KRT. The 5-year mortality rates declined after kidney failure but the decline was not statistically significant after KRT. Interpretation: The findings of our study highlight the importance of developing new strategies to prevent a looming epidemic of kidney failure in people with diabetes in Hong Kong. Funding: Asia Diabetes Foundation |
topic |
diabetes kidney failure kidney replacement therapy trend incidence mortality |
url |
http://www.sciencedirect.com/science/article/pii/S2666606521000742 |
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doaj-32bba31e96e3491bb7735c0209fe516c2021-06-11T05:16:10ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652021-06-0111100165Trends in kidney failure and kidney replacement therapy in people with diabetes in Hong Kong, 2002-2015: A retrospective cohort studyHongjiang Wu, PhD0Eric S.H. Lau, PhD1Aimin Yang, PhD2Cheuk-Chun Szeto, MD3Ronald C.W. Ma, FRCP4Alice P.S. Kong, MD5Elaine Chow, PhD6Wing-Yee So, MD7Juliana C.N. Chan, MD8Andrea O.Y. Luk, MD9Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Hospital Authority, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Corresponding author. Andrea O.Y Luk, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of ChinaBackground: There are limited population-wide trend data on kidney failure and kidney replacement therapy (KRT) in people with diabetes. We conducted a retrospective cohort study to report incidence trends of kidney failure and KRT and related mortality in people with diabetes in Hong Kong between 2002 and 2015. Methods: We used territory-wide electronic medical records including laboratory, diagnostic and procedural data to identify people with kidney failure and KRT. We used Joinpoint regression models to estimate the average annual percent change (AAPC) of kidney failure and KRT incidence for entire study period, and annual percent change (APC) for each linear trend segment, along with 1-year and 5-year mortality rates. Findings: During 4.9 million person-years of follow-up of 712,222 people with diabetes, 31,425 developed kidney failure, among whom 23.0% (n=7,233) received KRT. The incidence of kidney failure declined by 46.8% from 2002 to 2007 (APC: -11.6, 95% CI: -16.3, -6.7), then flattened from 2007 to 2015 (APC: -0.9, 95% CI: -3.1, 1.3). The incidence of KRT remained constant (AAPC: -1.6, 95% CI: -4.4, 1.2). The 1-year mortality rates declined statistically significantly after both kidney failure and KRT. The 5-year mortality rates declined after kidney failure but the decline was not statistically significant after KRT. Interpretation: The findings of our study highlight the importance of developing new strategies to prevent a looming epidemic of kidney failure in people with diabetes in Hong Kong. Funding: Asia Diabetes Foundationhttp://www.sciencedirect.com/science/article/pii/S2666606521000742diabeteskidney failurekidney replacement therapytrendincidencemortality |