DIABETIC-PATIENTS ON DIALYSIS - A CHANGING PICTURE

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.