Survival analysis of diabetic patients on dialysis in Guadeloupe

Background:Both diabetes and hypertension, two conditions that can lead to renal failure, have a high prevalence in Guadeloupe. Objective:To determine the clinical and epidemiological features of diabeti c patients on end stage renal failure and to evaluate their survival. Patients and method: Data of the Guadeloupe Kidney registry were analysed f or patients who began chronic dialysis during 1978-1997. Follow up informat ion on survival status was obtained up to January 26(th) 1999. Cox proporti onal hazard analysis was used to determine the relative risk (RR) of death between levels of independent variables. Results:There were 784 dialysis patients of whom 174 (22%) were diabetics. Among the latter, there were 97 women (55,7%), mean age at the start of dia lysis was 60.6 years (range 26-83) and arterial hypertension was present be fore the start of dialysis in 67% of them. Median survival MS (95%CI) was s ignificantly lower in diabetics 42 months (31-52) than in non diabetics 83 months (70-96), p < 10(-4). In diabetics, the cumulative probability of sur vival was 83% (1 year) and 39% (5 years) and the RR of death (95% CI) were 1.90 (1.10-3.22) and 3.43 (2.00-5.87) for diabetics admitted in dialysis in age-class 55-64 years and 65-83 years, respectively, when that for age-cla ss less than or equal to 54 years was set at 1.00. The RR for diabetics was 1.67 (1.33-2.10) relative to non diabetics. Conclusion: Prospective studies are warranted to describe the role of comor bid conditions in diabetic patients survival. Prevention of degenerative co mplications should be a priority in this population.