Growing incidence of diabetic nephropathy in the province of Badajoz during the period 1991-2006

Objective: Diabetic nephropathy is the most common cause for starting renal repacement therapy in Spain with a steady incidence since 1997. Data on incidence of diabetic nephropathy previously to dialysis are scanty because they are not registries similar to those used for renal replacement therapy. Design and methods: It have been retrospectively studied the records of our hospital Nephrology outward from January, 1991 to December, 2006. Diagnosis was commonly made using clinical criteria (proteinuria plus diabetic retinopathy). There were 21 cases which did not meet theses criteria and so renal biopsy was performed. Results: During this time 478 (49.7 pmp) patients were diagnosed of diabetic nephropathy (mean age 61.2 years, 50.4% women). Incidence increased from 33.3 pmp (1991) to 76.2 pmp (2006). There were not significant changes in the age of patients along the time. Other common diagnosis in diabetic patients were nefroangiosclerosis (129) and glomerulonefritis (n = 103). Survival until renal replacement therapy was 87.5% at one year and 48% at five years of follow up. Conclusions: Incidence of diabetic nephropathy seems to have increase last years specially in the patients aged 70 or older. In spite of therapeutic improvements the prognosis is still unfavourable. Less rectricted age criteria for submitting patients may have influenced these results.