DISCONTINUATION OF TREATMENT AMONG ITALIAN DIABETIC-PATIENTS TREATED BY RENAL REPLACEMENT THERAPY

Death from dialysis termination has been extensively surveyed in Canad a, the United States, and Australia. In the US old age and the presenc e of diabetes has been associated with treatment withdrawal. On the ot her hand, information for Europe is very scarce. We addressed the issu e of dialysis termination in Italy in both a cohort of diabetic patien ts starting RRT in 1987, and two age-, sex-, type of RRT, and unit-mat ched cohorts of diabetic and non-diabetic patients alive on RRT treatm ent on 31 December 1987. Follow-up was available till 31 December 1991 . Dialysis termination accounted for 1.1% of the known causes of death in the incident diabetic cohort and for only 0.5% and 0.9% of the pre valent diabetic and non-diabetic cohorts respectively. In Italy, diabe tes is not associated with higher rates of dialysis termination and th is cause of death seems uncommon among the overall Italian RRT populat ion. We cannot, however, exclude a predialysis selection against patie nts presenting with an old age or comorbid conditions.