Kidney Res Clin Pract.  2024 Jan;43(1):20-32. 10.23876/j.krcp.23.130.

Status and trends in epidemiologic characteristics of diabetic end-stage renal disease: an analysis of the 2021 Korean Renal Data System

Affiliations
  • 1Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Republic of Korea
  • 2The Korean Society of Nephrology, Seoul, Republic of Korea
  • 3Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  • 4Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  • 5Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
  • 6Department of Internal Medicine, Samyook Medical Center, Seoul, Republic of Korea
  • 7Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
  • 8Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • 9Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea
  • 10Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
  • 11Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
  • 12Yoon’s Medical Clinic Dialysis Center, Seoul, Republic of Korea
  • 13Seoul One Clinic, Anyang, Republic of Korea
  • 14Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine Iksan, Republic of Korea
  • 15Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
  • 16Cell Death Disease Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  • 17Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Abstract

Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.

Keyword

Chronic kidney disease; Diabetes mellitus; Dialysis; End-stage renal disease; Mortality
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