Prevalence of diabetic patients on dialysis is often considered a mark
er of overall acceptance rate for dialysis; however, even when accepta
nce policy is open, incidence of diabetic patients varies widely. Epid
emiological differences of diabetes incidence all over the world partl
y explain the discrepancies. Incidence of diabetic patients accepted f
or dialysis (1981 to 82: 6 p.m.p.; 1989 to 90: 11.5 p.m.p.) differs ac
cording to age and sex in the setting analyzed (Piedmont, Northern Ita
lian region, about 4,400,000 inhabitants, 20 dialysis centers, open ac
ceptance since the mid-70s, yearly information on 100% of patients, ga
thered by a Dialysis and Transplantation Registry). Patterns changed r
emarkably during the 10 years considered (1981 to 90). Incidence was h
igher in males (10.4 p.m.p. in the period 1981 to 90), with a peak at
ages 60 to 69. Incidence remained relatively stable in the younger pat
ients, but increased in the elderly. mainly in males, rising from 6.23
in 1981 to 82 to 12.88 p.m.p. in 1989 to 90 (males, all ages). In con
clusion, the demographic characteristics of diabetic patients with ESR
D accepted for dialysis is changing. The stability of incidence of you
nger patients reassures about the open acceptance policy, at least in
these ages. The increase in the elderly probably reflects the longer l
ifespan of diabetic patients in the overall population. The possibilit
y of a hidden preselection must be further assessed. Future provisions
of dialysis needs must take into account the trend towards an increas
e of this high risk, elderly population.