Slowly progressive subtype of childhood-onset type 1 diabetes as a high-risk factor for end-stage renal disease: A cohort study in Japan

Aim: To compare the incidence of end-stage renal disease (ESRD) between slowly progressive type 1 diabetes and acute-onset type 1 diabetes. Methods: This cohort study enrolled all 521 patients with childhood-onset type 1 diabetes with the year of onset from 1959 to 1996 in Hokkaido Prefecture, Japan. We calculated the ESRD incidence rate per 100,000 person- years by sex, onset year, onset age, and type 1 diabetes subtype (slowly progressive or acute-onset). We also constructed a Kaplan-Meier curve for ESRD by these risk factors. Results: The data of 391 patients were gathered, among whom 66 developed ESRD. The ESRD incidence rate per 100,000 person-years was 525 among all patients; 538 and 503 among women (n = 235) and men (n = 156); 893, 413, and 225 for onset year of 1959-1979 (n = 107), 1980-1989 (n = 201), and 1990-1996 (n = 83); 420 and 715 for onset before (n = 243) and after (n = 148) puberty; and 1388 and 432 for the slowly progressive (n = 41) and acute-onset (n = 350) subtypes, respectively. The Kaplan-Meier curve also indicated a significantly higher incidence of ESRD in slowly progressive than in acute-onset type 1 diabetes. Conclusion: The incidence of ESRD was higher in slowly progressive than acute-onset type 1 diabetes.