Type 1 and type 2 diabetes and cancer mortality in the 2002-2009 cohort of 39,811 French dialyzed patients

End-stage renal disease is a chronic and progressive pathology associated with several comorbidities, particularly diabetes. Indeed, diabetes is the first cause of end-stage renal disease and, in France, 42% of incident patients had diabetes in 2012. In the general population, diabetes is associated...

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Bibliographic Details
Published in:PloS one 2015-05, Vol.10 (5), p.e0125089
Main Authors: Pladys, Adélaïde, Couchoud, Cécile, LeGuillou, Aurélie, Siebert, Muriel, Vigneau, Cécile, Bayat, Sahar
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis
Cancer
Cancer therapies
Cardiovascular diseases
Chronic illnesses
Chronic kidney failure
Comorbidity
Complications and side effects
Death
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - epidemiology
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - epidemiology
Dialysis
End-stage renal disease
Epidemiology
Female
France - epidemiology
Genetics
Health risks
Humans
Insulin resistance
Insulin-like growth factors
Kidney diseases
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - therapy
Kidney transplantation
Life Sciences
Male
Middle Aged
Mortality
Neoplasms - etiology
Neoplasms - mortality
Patient outcomes
Patients
Peritoneal dialysis
Peritoneum
Retrospective Studies
Risk
Risk Factors
Santé publique et épidémiologie
Transplantation
Transplants & implants
Tumors
Type 2 diabetes
Vascular diseases
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Summary:End-stage renal disease is a chronic and progressive pathology associated with several comorbidities, particularly diabetes. Indeed, diabetes is the first cause of end-stage renal disease and, in France, 42% of incident patients had diabetes in 2012. In the general population, diabetes is associated with increased cancer risk. The aim of this study was to examine the association between risk of cancer death and diabetes in a large French cohort of patients with end-stage renal disease. Data on all patients with end-stage renal disease who initiated dialysis in France between 2002 and 2009 were extracted from the Renal Epidemiology Information Network registry. The risk of dying by cancer was studied using the Fine and Gray model to take into account the competing risk of death by other causes. We analyzed 39,811 patients with end-stage renal disease. Their mean age was 67.7±15 years, 39.4% had diabetes and 55.3% at least one cardiovascular disease. Compared with the non-diabetic group, patients with diabetes were older and had more cardiovascular and respiratory comorbidities when they started dialysis. Conversely, fewer diabetic patients had also a tumor at the beginning of the renal replacement therapy. Cancer was indicated as the cause of death for 6.7% of diabetic and 13.4% of non-diabetic patients. The Fine and Gray multivariate analyses indicated that diabetes (HR=0.72 95% CI: [0.68-0.95], p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0125089